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Functional treatment of metacarpal fractures 100 randomized cases with or without fixation
Konradsen L, Nielsen PT, Albrecht-Beste E
Acta Orthopaedica Scandinavica 1990;61(6):531-534
clinical trial
3/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

Totally, 100 hundred subcapital or diaphyseal fractures of the second through the fifth metacarpal were randomized to either a dorsal/ulnar plaster cast immobilizing the wrist and the joints of the involved digits or a functional cast allowing the wrist and the digits a free range of motion. Due to better retaining ability, functional casting reduced volar angulation by two thirds for metacarpal shaft fractures and by one third for metacarpal neck fractures when compared with plaster cast immobilization. Restriction of wrist, metacarpophalangeal, and interphalangeal joint movements was more frequent in the cast group, but did not influence the overall function 3 months postinjury. Sick leave was reduced by two thirds after functional casting compared with the plaster cast group.

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