Duration of Fracture Brace for Metacarpal Shaft Fracture of Fourth Finger
A fracture brace for a metacarpal shaft fracture of the fourth finger should typically be worn for 4-6 weeks, with functional bracing allowing for earlier mobilization being preferred over rigid immobilization when appropriate.
Immobilization Duration Guidelines
- Standard immobilization time for metacarpal shaft fractures is 4-6 weeks, with clinical and radiographic assessments recommended at regular intervals to monitor healing 1
- Complete fracture healing is typically observed in 100% of cases by 2 months post-injury, with partial healing (37% of cases) visible at 1 month 2
- For surgically treated metacarpal shaft fractures, traditional rehabilitation protocols recommend return to full activities at 6-8 weeks post-operative, though accelerated protocols may allow earlier return in select cases 3
Types of Immobilization
- Functional bracing after operative treatment of metacarpal fractures has shown good outcomes with reduced need for physical therapy compared to rigid immobilization 4
- For minimally displaced fractures (angulation less than 10 degrees), buddy taping may be sufficient, while larger angulations often require more rigid immobilization or surgical intervention 1
- Rigid immobilization is suggested over removable splints for displaced fractures, while removable splints are an option for minimally displaced fractures 5
Monitoring and Follow-up
- Radiographic assessment is recommended at regular intervals during the immobilization period to monitor fracture alignment and healing 6, 7
- Standard 3-view radiographic examination (posteroanterior, lateral, and oblique views) is necessary for proper evaluation of metacarpal fractures 7
- Clinical assessment should include evaluation of range of motion, grip strength, and functional outcomes 2
Considerations for Early Mobilization
- Buddy taping for four weeks with immediate active protected mobilization has shown good functional outcomes for minimally displaced metacarpal fractures 2
- Secondary displacement may occur in approximately 11% of cases with early mobilization, but functional results remain good with minimal pain and stiffness by 2 months 2
- Early finger motion exercises are recommended following diagnosis of fractures to prevent stiffness, which can be a functionally disabling adverse effect 5
Common Pitfalls and Complications
- Finger stiffness is one of the most functionally disabling complications of hand fractures and can be difficult to treat after fracture healing 5
- Failure to instruct patients on regular finger motion through complete range of motion may increase risk of stiffness 5
- Inadequate radiographic monitoring may lead to missed secondary displacement, which occurs in approximately 11% of cases with functional treatment 2
- Prolonged immobilization may lead to unnecessary stiffness and longer rehabilitation periods 4
Special Considerations
- Athletes and high-demand patients may benefit from accelerated rehabilitation protocols, with some professional athletes returning to sport within four weeks following surgical fixation 3
- The need for physical therapy is reduced with functional fracture bracing compared to rigid immobilization, with only 41% of patients requiring further therapy after brace removal 4
- Grip strength typically reaches 88-98% of the contralateral side by 2 months with appropriate management 4