Splint Type for Non-Displaced 3rd Metacarpophalangeal (MCP) Fracture
For a non-displaced 3rd metacarpophalangeal fracture, a hand-based functional splint that immobilizes the fracture while allowing for finger motion is recommended. 1, 2
Recommended Splint Type and Configuration
- A hand-based functional splint is the preferred option for non-displaced metacarpal fractures as it maintains fracture reduction while allowing for early mobility 2
- The splint should be custom-molded to immobilize the fracture site while permitting metacarpophalangeal (MCP) joint, interphalangeal joint, and radiocarpal joint motion 2
- This type of splint has shown excellent maintenance of fracture reduction with low patient morbidity 2
Advantages of Hand-Based Functional Splinting
- Allows for early finger motion which prevents stiffness, one of the most functionally disabling complications of hand fractures 1
- Enables patients to maintain functional motion throughout treatment 2
- Facilitates earlier return to pre-injury activities compared to rigid immobilization 2
- Can be removed for hygiene purposes and radiographic evaluations 3
Duration of Splinting
- The average duration of splinting for metacarpal fractures is approximately 24 days 2
- Radiographic follow-up is recommended at approximately 3 weeks and at the time of immobilization removal to confirm adequate healing 1
Important Rehabilitation Considerations
- Active finger motion exercises should be performed following diagnosis to prevent stiffness 1
- Finger motion does not adversely affect adequately stabilized fractures 1
- Early mobilization helps prevent joint stiffness while allowing for proper bone healing 3
Special Considerations and Precautions
- For fractures with significant displacement (>3mm), dorsal tilt (>10°), or intra-articular involvement, surgical management may be indicated instead of conservative treatment 1
- The position of the MCP joint during immobilization (flexed or extended) has been shown to have little effect on final motion, grip strength, or fracture alignment when immobilization is discontinued by 5 weeks 4
- Two-component thermoplastic splints can be particularly effective as they allow for bone healing and recovery of motion simultaneously 3