Splint Type for 3rd Digit Metacarpal Hairline Fracture
For a 3rd digit metacarpal hairline fracture, a hand-based functional splint that immobilizes the fracture site while allowing for finger motion is recommended to prevent stiffness and promote healing. 1
Splint Selection and Application
- A hand-based functional splint is the preferred option for non-displaced or minimally displaced metacarpal fractures, as it provides adequate stabilization while maintaining mobility 1, 2
- The splint should be designed to immobilize the metacarpal fracture site while allowing for metacarpophalangeal joint, interphalangeal joint, and radiocarpal joint motion 2
- Standard 3-view radiographic examination should be performed to confirm proper alignment before and after splint application 3
- For metacarpal fractures, CT or MRI is usually not indicated during acute injury unless there is concern for occult injury not visible on radiographs 3
Benefits of Hand-Based Functional Splinting
- Allows for excellent maintenance of fracture reduction while preserving functional motion throughout treatment 2
- Enables early or immediate return to pre-injury activities with low patient morbidity 2
- Prevents stiffness, which is one of the most functionally disabling adverse effects of hand fractures 1, 4
- Active finger motion exercises should be performed following diagnosis to prevent stiffness 1
- Finger motion does not adversely affect adequately stabilized metacarpal fractures in terms of reduction or healing 1, 4
Duration of Splinting and Follow-Up
- Radiographic follow-up is recommended at approximately 3 weeks to confirm adequate healing 1
- The average splint duration for metacarpal fractures is about 24 days 2
- Active finger motion exercises should be continued throughout the healing process 1
When to Consider Alternative Treatment
- If there is significant displacement (>3mm), dorsal tilt (>10°), or intra-articular involvement, surgical management may be indicated instead of conservative treatment 1, 5
- Unstable fractures, malrotated fractures, or those with significant angulation may require internal fixation rather than splinting alone 6
- For the 3rd metacarpal specifically, angulation greater than 10 degrees may require reduction or surgical intervention 7
Practical Considerations
- Buddy splinting can be used for minimal angulation (less than 10 degrees) in conjunction with the hand-based splint 7
- Most metacarpal fractures can be treated successfully by closed reduction and splint immobilization 6
- The functional hand-based splint has shown excellent results in maintaining fracture reduction while allowing patients to continue working and performing daily activities 2