A prospective study of the treatment of fractures of the little finger metacarpal shaft with a short hand cast

This prospective study describes the use of a short hand cast, which leaves the finger metacarpophalangeal and wrist joint free, for angularly displaced little finger metacarpal shaft fractures which require reduction. Twenty-seven patients with a mean age of 25 (range, 16–39) years with little finger or combined ring and little finger displaced metacarpal shaft fractures were prospectively recruited. All were treated by closed fracture reduction and immobilization in the cast. Patients were followed up at 1 week, 4 weeks, and between 6 and 12 months. At each of these follow-up visits posteroanterior and lateral radiographs of the metacarpals were performed to assess angulation of the fracture. The mean initial angulation of the 17 little finger metacarpal fractures with complete follow up was 40° (range, 20–60°). Their mean final angulation at 6 to 12 months was 8°. The fracture reduction was lost in three patients in whom the final angular deformities were 15° (one patient) and 20° (two patients). Journal of Hand Surgery (British and European volume, 2004)