Splinting for Non-Displaced 3rd Metacarpal Fracture
A hand-based functional splint is recommended for a non-displaced 3rd metacarpal fracture as it provides excellent maintenance of fracture reduction while allowing functional motion throughout treatment. 1
Splint Selection Criteria
- For non-displaced metacarpal fractures, a hand-based functional splint is preferred over rigid immobilization as it allows for maintenance of joint mobility while providing adequate stabilization 1
- The splint should immobilize the fracture site while allowing for finger motion to prevent stiffness 2
- A hand-based splint that permits metacarpophalangeal joint, interphalangeal joint, and radiocarpal joint motion is ideal for non-displaced metacarpal fractures 1
Splint Application Technique
- The splint should be positioned to maintain proper alignment of the 3rd metacarpal without restricting finger motion 1
- For metacarpal fractures, the splint should allow for metacarpophalangeal joint flexion of 60-90 degrees while maintaining extension of the fingers 3
- A standard 3-view radiographic examination should be performed to confirm proper alignment before and after splint application 4
Duration of Splinting
- The average duration of splinting for metacarpal fractures is approximately 24 days 1
- Radiographic follow-up is recommended at approximately 3 weeks to confirm adequate healing 2
- Early functional treatment should be initiated as soon as possible for stable, non-displaced fractures 3
Rehabilitation Considerations
- Active finger motion exercises should be performed following diagnosis to prevent stiffness 2
- Early mobilization is a critical component of treatment to prevent stiffness and restore function 5
- Finger motion does not adversely affect adequately stabilized metacarpal fractures 2
Advantages of Hand-Based Functional Splinting
- Allows for excellent maintenance of fracture reduction 1
- Enables early or immediate return to pre-injury activities 1
- Results in low patient morbidity 1
- Maintains functional motion throughout treatment 1
- Demonstrates high patient satisfaction rates 6
When to Consider Alternative Treatment
- If the fracture shows displacement of over 30 degrees, shortening of over 5mm, joint involvement, or rotational deformity, surgical management may be indicated 3, 7
- For fractures with significant displacement (>3mm), dorsal tilt (>10°), or intra-articular involvement, surgical management may be indicated instead of conservative treatment 2
- Open fractures and serial fractures of metacarpal bones typically require surgical intervention rather than splinting 3