母指球骨骨折に対する手の機能回復プログラムの効果：システマティックレビューおよびメタアナリシス

Non-thumb metacarpal fractures (II-V) are prevalent hand injuries that can severely compromise hand function, grip strength, and range of motion (ROM) if not appropriately rehabilitated. Various rehabilitation strategies - ranging from physiotherapy and home-based exercises to early mobilization and gamification - have been introduced, but their relative effectiveness remains unclear.

This meta-analysis aimed to evaluate and compare the effectiveness of different rehabilitation programs for non-thumb metacarpal fractures, focusing on improvements in hand function, grip strength, and ROM.

A comprehensive literature search was conducted across PubMed, Web of Science, and Scopus from inception to January 2025. Randomized controlled trials (RCTs) and cohort studies evaluating rehabilitation for non-thumb metacarpal fractures were included. Interven-tions studied included conventional physiotherapy, home-based exercise, gamification, early mobilization, and immobilization techniques (e.g., buddy taping vs. plaster). Data extraction and bias assessments were performed independently by two reviewers. Meta-analyses were conducted using Review Manager 5.4. This study was preregistered with PROSPERO (CRD42024619888).

Five studies (three RCTs, two cohort studies) met the inclusion criteria. Rehabilitation significantly improved hand function (SMD = -1.04, 95% CI: -1.54 to -0.54), grip strength (MD = 21.33, 95% CI: 18.81 to 23.83), and ROM (MD = 23.43, 95% CI: 20.15 to 26.72). Early mobilization and gamification strategies were associated with enhanced functional outcomes and patient adherence.

Structured rehabilitation programs, especially those incorporating early mobilization and digital adherence strategies, are effective in improving outcomes for non-thumb metacarpal fractures. Minimal immobilization approaches such as buddy taping may be suitable for stable fractures.