J Korean Soc Surg Hand.  2015 Dec;20(4):161-167. 10.12790/jkssh.2015.20.4.161.

Modified Split Ulnar Gutter Splint for Treatment of Fifth Metacarpal Neck Fractures

• Gil HJ
• Chung YG
• Shin SH
• Kim DH
• Kang JW
• Jeon SH

• KMID: 2150397
• DOI: http://doi.org/10.12790/jkssh.2015.20.4.161

Abstract

PURPOSE
To evaluate radiological results of the modified split ulnar gutter splint for the fifth metacarpal neck fracture.
METHODS
Between December 2008 and May 2014, 17 patients (18 cases) with fifth metacarpal neck fractures were managed with our modified split ulnar gutter splint. Radiological outcomes in oblique and lateral radiographs were evaluated. Mean immobilization period was 4.9 weeks (range, 4-7) weeks. Mean follow-up period was 17.1 week (range, 8-80 weeks).
RESULTS
All of 18 fractures were completely united. The average of prereduction dorsal angulation, 27degrees in the oblique radiographs and 21degrees in the lateral radiographs, were corrected to 17degrees in the oblique radiographs and 10degrees in the lateral radiographs after closed reduction. At the last follow-up, they were 14degrees and 11degrees respectively. The mean difference of angulation deformity between in postreduction and final follow-up radiograms were 3degrees in the oblique radiographs and 1degrees in the lateral radiographs, which was not significantly different.
CONCLUSION
Immobilization using modified split ulnar gutter splint will be a reliable option for the fifth metacarpal neck fractures in selected patients, which will avoid the surgeries.

Keyword

Fifth metacarpal neck fracture; Closed reduction; Ulnar gutter splint

MeSH Terms

Congenital Abnormalities
Follow-Up Studies
Humans
Immobilization
Neck*
Splints*

Figure

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  Fig. 1. Reduction method under image intensifier. Longitudinal traction applied while proximal phalanx was elevated toward dorsal direction and metacarpal shaft put down.

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  Fig. 2. Molding method of modified split ulnar gutter splint.

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  Fig. 3. (A) A 50-year-old man sustained a fifth metacarpal neck fracture with 24.5° angulation deformity on oblique radiograph, 18° angulation on lateral radiograph. (B) Post-reduction radiographs show 14.4°, 9° residual angulation on oblique and lateral radiographs, respectively. (C) 24-month follow-up radiographs show good union without any reduction loss or rotationalde deformity.

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  Fig. 4. (A) A 28-year-old man sustained a fifth metacarpal neck fracture with 16.5° angulation deformity on oblique radiograph, 6° angulation on lateral radiograph. (B) Post-reduction radiographs show 1.6°, 2° residual angulation on oblique and lateral radiographs, respectively. (C) 10-week follow-up radiographs show good union and 2.3°, 2° angulation on oblique and lateral radiographs, respectively.

Reference

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