Multiple metacarpal fractures: Is it possible to achieve satisfactory outcomes after conservative treatment?

Abstract

Objective: To evaluate the effects of surgical and conservative treatment on quality of life in patients with multiple metacarpal fractures. Patients and Methods: A retrospective review of patients with multiple metacarpal fractures was conducted, with a focus on their demographic characteristics, injury mechanisms, associated upper extremity fractures, and fracture patterns. The Quick Disabilities of the Arm, Shoulder and Hand (QDASH) score, along with the Physical Component Score (PCS-12) and the Mental Component Score (MCS-12) of the Short Form-12 (SF-12) Health Survey, were utilized to analyze functional outcomes. Results: Among the 31 multiple metacarpal fracture patients, the surgery/conservative ratio was 24/7. No disparities were found between groups in terms of demographic variables. A significant difference was observed in terms of concomitant upper extremity fractures between patients who underwent conservative and surgical treatment (p=0.038). Conservative treatment was not applied to any patient with concomitant upper extremity fractures. QDASH scores were significantly lower in the surgical intervention group (p<0.001). No difference was observed between groups in terms of PCS-12 (p=0.391). However, MCS-12 scores were significantly lower in the surgical group (p=0.033). Interestingly, MCS-12 scores were also significantly lower among patients with concomitant upper extremity fractures (p=0.043). Conclusion: Although conservative treatment can be appropriate for certain cases of multiple metacarpal fractures, surgical intervention was associated with superior functional outcomes in this cohort.

Keywords

• Multiple metacarpal fractures
• QDASH Score
• Conservative management
• SF-12

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