Metacarpal Fracture stable fixation low risk therapy

The patient is fitted with a protective thermoplastic splint which is to be worn between active range of motion exercises. The nature of the splint will depend on the nature and location of the fracture.

Active range of motion exercises are initiated to all joints four to six times daily.

1 - 3 weeks:

When sutures are removed, scar massage is instituted to reduce adhesions around the extensor tendons.

Dynamic splinting may be used as needed to reduce joint and/or tendon tightness when the fracture is stable.

Two weeks after clinical union, the patients are allowed prehension, lifting five pounds or less.

Four weeks after clinical union, the patients are started on resistive exercises and can return to light work duties lifting less than 25 pounds. Protective splinting is discontinued at this point except for sports level activities.

Eight weeks after clinical union, patients are released to sports level activities and medium or heavy work.

8 weeks:

Begin gentle strengthening with soft putty, progressing to a hand helper.

Discontinue splinting as possible when motion is obtained and the fracture/s are healed.

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