[Conservative or surgical treatment of metacarpal fractures]

A total of 146 patients with 150 closed metacarpal fractures were treated between 1980 and 1981, and 109 patients with 113 metacarpal fractures (75%) were followed up (follow up 7.3 years). After conservative treatment, the functional results were good to excellent in 92.7%, while 5.8% had satisfactory and 1.5% poor functional results. After operative treatment 81.5% had good or excellent functional results, 14.8% satisfactory results and 3.7%, poor functional results. The radiological result did not correspond with the functional result. Angulation of the Ist-IVth metacarpal bones by up to 20 degrees of the Vth metacarpal bone by up to 50 degrees, and even shortening by up to 8 mm had no detrimental influence on the functional results. Axial rotational deviation of the Vth metacarpal bone by up to 15 degrees was tolerated. Joint fractures with a 1 mm step could also be treated by conservatively means.