Is Routine Outpatient Follow-up Required in Fifth Metacarpal Neck Fractures?

Abstract

Aim:To investigate the factors affecting the healed angulation in patients treated with closed reduction and casting for a fifth metacarpal neck fracture.Materials and Methods:The study consisted of sixty-three patients with a fifth metacarpal neck fracture, who had an angulation 30° as groups 1 and 2, respectively). The angles of the fifth metacarpal neck fracture were measured at presentation, after reduction, and at the final follow-up visit.Results:Of the sixty-three patients, thirty healed with acceptable angulation (Group 1) and thirty-three with unacceptable angulation (Group 2). There was not a statistically significant difference between two groups according to the mean age, follow-up time, metacarpophalangeal cast angle, wrist extension cast angle, and correction angle. The mean initial fracture angulation was 41.7°±12.9° (9°-70°) in Group 1 and 48.3°±9.9° (29°-70°) in Group 2 (p=0.049). The mean fracture angulation after the reduction was 15.5°±8.9° (0-30°) in Group 1 and 26°±4.8° (15°-30°) in Group 2 (p44° and >17° for unacceptable result of initial and post-reduction angulations, respectively.Conclusion:In the patients with fifth metacarpal neck fracture treated with closed reduction and casting, the initial angle <44° and the angulation after reduction <17° are positive indicators for functional recovery. Routine follow-up may not be required in this group of patients.

Keywords

• metacarpophalangeal neck
• fifth metacarpal fracture
• closed reduction and cast