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

Year 2026, Volume: 39 Issue: 1, 39 - 45, 28.01.2026
https://doi.org/10.5472/marumj.1873034

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.

References

  • Pérez-Serna AG, Figueroa-Cal y Mayor F. Fractura-luxación carpometacarpiana múltiple [Multiple carpometacarpal fracture-dislocation]. Acta Ortop Mex 2009; 23:149-52. Spanish.
  • Kollitz KM, Hammert WC, Vedder NB, Huang JI. Metacarpal fractures: treatment and complications. Hand (N Y) 2014; 9:16-23. doi: 10.1007/s11552-013-9562-1.
  • Retrouvey H, Morzycki A, Wang AMQ. Canadian Plastic Surgery Research Collaborative; Binhammer P. Are we over treating hand fractures? Current practice of single metacarpal fractures. Plast Surg (Oakv) 2018; 26:148-53. doi: 10.1177/229.255.0318767926.
  • Meunier MJ, Hentzen E, Ryan M, Shin AY, Lieber RL. Predicted effects of metacarpal shortening on interosseous muscle function. J Hand Surg Am 2004; 29:689-93. doi: 10.1016/j.jhsa.2004.03.002.
  • Strauch RJ, Rosenwasser MP, Lunt JG. Metacarpal shaft fractures: the effect of shortening on the extensor tendon mechanism. J Hand Surg Am 1998; 23:519-23. doi: 10.1016/ S0363-5023(05)80471-X.
  • Carreño A, Ansari MT, Malhotra R. Management of metacarpal fractures. J Clin Orthop Trauma 2020; 11:554-61. doi: 10.1016/j.jcot.2020.05.043.
  • Manueddu CA, Della Santa D. Fasciculated intramedullary pinning of metacarpal fractures. J Hand Surg Br 1996; 21:230- 6. doi: 10.1016/s0266-7681(96)80104-5.
  • Geissler WB. Operative fixation of metacarpal and phalangeal fractures in athletes. Hand Clin 2009; 25:409-21. doi: 10.1016/j. hcl.2009.05.005.
  • Kozin SH, Thoder JJ, Lieberman G. Operative treatment of metacarpal and phalangeal shaft fractures. J Am Acad Orthop Surg 2000; 8:111-21. doi: 10.5435/00124635-200003000-00005
  • Lambi AG, Rowland RJ, Brady NW, Rodriguez DE, Mercer DM. Metacarpal fractures. J Hand Surg Eur 2023; 48(2_ suppl):42S-50S. doi: 10.1177/175.319.34231184119.
  • Blazar PE, Leven D. Intramedullary nail fixation for metacarpal fractures. Hand Clin 2010; 26:321-5, v. doi: 10.1016/j.hcl.2010.05.005.
  • Diaz-Garcia R, Waljee JF. Current management of metacarpal fractures. Hand Clin 2013; 29:507-18. doi: 10.1016/j. hcl.2013.09.004.
  • Taha RHM, Grindlay D, Deshmukh S, Montgomery A, Davis TRC, Karantana A. A Systematic review of treatment interventions for metacarpal shaft fractures in adults. Hand (N Y) 2022; 17:869-78. doi: 10.1177/1558944720974363.
  • Meinberg EG, Agel J, Roberts CS, Karam MD, Kellam JF. Fracture and Dislocation Classification Compendium-2018. J Orthop Trauma 2018; 32(Suppl 1):S1-S170. doi: 10.1097/ BOT.0000000000001063.
  • Beaton DE, Wright JG, Katz JN. Upper Extremity Collaborative Group. Development of the QuickDASH: comparison of three item-reduction approaches. J Bone Joint Surg Am 2005; 87:1038-46. doi: 10.2106/JBJS.D.02060.
  • Franchignoni F, Vercelli S, Giordano A, Sartorio F, Bravini E, Ferriero G. Minimal clinically important difference of the disabilities of the arm, shoulder and hand outcome measure (DASH) and its shortened version (QuickDASH). J Orthop Sports Phys Ther 2014; 44:30-9. doi: 10.2519/jospt.2014.4893.
  • Gosling CM, Gabbe BJ, Williamson OD, Sutherland AM, Cameron PA. Validity of outcome measures used to assess one and six month outcomes in orthopaedic trauma patients. Injury 2011; 42:1443-8. doi: 10.1016/j.injury.2011.05.022.
  • Bozduman Ö, Yadigaroğlu M, Okutan AE, Süren M, Güçlü B. Comparison of pain catastrophic scale and anxiety in patients with Boxer’s fracture and other types of hand fractures. Cureus 2023; 15:e35019. doi: 10.7759/cureus.35019.
  • Poolman RW, Goslings JC, Lee JB, Statius Muller M, Steller EP, Struijs PA. Conservative treatment for closed fifth (small finger) metacarpal neck fractures. Cochrane Database Syst Rev 2005; 2005:CD003210. doi: 10.1002/14651858.CD003210. pub3.
  • Adıyeke L, Aydogmus S, Sabuncuoğlu M, Bilgin E, Duymus TM. Effects of psychological factors on the clinical outcomes of fifth metacarpal neck fractures and their relation to injury etiology. Ulus Travma Acil Cerrahi Derg 2019; 25:403-9. English. doi: 10.5505/tjtes.2018.93928.
  • Kart H, Akça E. Do patients with dominant-side distal radius fractures have greater psychological distress than those with nondominant-side fractures? Clin Orthop Relat Res 2025; 483:279-85. doi: 10.1097/CORR.0000000000003244.
  • Wormald J, Claireaux HA, Gardiner MD, Jain A, Furniss D, Costa ML. Management of extra-articular fractures of the fifth metacarpal: Operative vs. Non-operative Treatment (FORTE) – A systematic review and meta-analysis. JPRAS Open 2019; 20:59-71. doi: 10.1016/j.jpra.2019.02.001.

Year 2026, Volume: 39 Issue: 1, 39 - 45, 28.01.2026
https://doi.org/10.5472/marumj.1873034

Abstract

References

  • Pérez-Serna AG, Figueroa-Cal y Mayor F. Fractura-luxación carpometacarpiana múltiple [Multiple carpometacarpal fracture-dislocation]. Acta Ortop Mex 2009; 23:149-52. Spanish.
  • Kollitz KM, Hammert WC, Vedder NB, Huang JI. Metacarpal fractures: treatment and complications. Hand (N Y) 2014; 9:16-23. doi: 10.1007/s11552-013-9562-1.
  • Retrouvey H, Morzycki A, Wang AMQ. Canadian Plastic Surgery Research Collaborative; Binhammer P. Are we over treating hand fractures? Current practice of single metacarpal fractures. Plast Surg (Oakv) 2018; 26:148-53. doi: 10.1177/229.255.0318767926.
  • Meunier MJ, Hentzen E, Ryan M, Shin AY, Lieber RL. Predicted effects of metacarpal shortening on interosseous muscle function. J Hand Surg Am 2004; 29:689-93. doi: 10.1016/j.jhsa.2004.03.002.
  • Strauch RJ, Rosenwasser MP, Lunt JG. Metacarpal shaft fractures: the effect of shortening on the extensor tendon mechanism. J Hand Surg Am 1998; 23:519-23. doi: 10.1016/ S0363-5023(05)80471-X.
  • Carreño A, Ansari MT, Malhotra R. Management of metacarpal fractures. J Clin Orthop Trauma 2020; 11:554-61. doi: 10.1016/j.jcot.2020.05.043.
  • Manueddu CA, Della Santa D. Fasciculated intramedullary pinning of metacarpal fractures. J Hand Surg Br 1996; 21:230- 6. doi: 10.1016/s0266-7681(96)80104-5.
  • Geissler WB. Operative fixation of metacarpal and phalangeal fractures in athletes. Hand Clin 2009; 25:409-21. doi: 10.1016/j. hcl.2009.05.005.
  • Kozin SH, Thoder JJ, Lieberman G. Operative treatment of metacarpal and phalangeal shaft fractures. J Am Acad Orthop Surg 2000; 8:111-21. doi: 10.5435/00124635-200003000-00005
  • Lambi AG, Rowland RJ, Brady NW, Rodriguez DE, Mercer DM. Metacarpal fractures. J Hand Surg Eur 2023; 48(2_ suppl):42S-50S. doi: 10.1177/175.319.34231184119.
  • Blazar PE, Leven D. Intramedullary nail fixation for metacarpal fractures. Hand Clin 2010; 26:321-5, v. doi: 10.1016/j.hcl.2010.05.005.
  • Diaz-Garcia R, Waljee JF. Current management of metacarpal fractures. Hand Clin 2013; 29:507-18. doi: 10.1016/j. hcl.2013.09.004.
  • Taha RHM, Grindlay D, Deshmukh S, Montgomery A, Davis TRC, Karantana A. A Systematic review of treatment interventions for metacarpal shaft fractures in adults. Hand (N Y) 2022; 17:869-78. doi: 10.1177/1558944720974363.
  • Meinberg EG, Agel J, Roberts CS, Karam MD, Kellam JF. Fracture and Dislocation Classification Compendium-2018. J Orthop Trauma 2018; 32(Suppl 1):S1-S170. doi: 10.1097/ BOT.0000000000001063.
  • Beaton DE, Wright JG, Katz JN. Upper Extremity Collaborative Group. Development of the QuickDASH: comparison of three item-reduction approaches. J Bone Joint Surg Am 2005; 87:1038-46. doi: 10.2106/JBJS.D.02060.
  • Franchignoni F, Vercelli S, Giordano A, Sartorio F, Bravini E, Ferriero G. Minimal clinically important difference of the disabilities of the arm, shoulder and hand outcome measure (DASH) and its shortened version (QuickDASH). J Orthop Sports Phys Ther 2014; 44:30-9. doi: 10.2519/jospt.2014.4893.
  • Gosling CM, Gabbe BJ, Williamson OD, Sutherland AM, Cameron PA. Validity of outcome measures used to assess one and six month outcomes in orthopaedic trauma patients. Injury 2011; 42:1443-8. doi: 10.1016/j.injury.2011.05.022.
  • Bozduman Ö, Yadigaroğlu M, Okutan AE, Süren M, Güçlü B. Comparison of pain catastrophic scale and anxiety in patients with Boxer’s fracture and other types of hand fractures. Cureus 2023; 15:e35019. doi: 10.7759/cureus.35019.
  • Poolman RW, Goslings JC, Lee JB, Statius Muller M, Steller EP, Struijs PA. Conservative treatment for closed fifth (small finger) metacarpal neck fractures. Cochrane Database Syst Rev 2005; 2005:CD003210. doi: 10.1002/14651858.CD003210. pub3.
  • Adıyeke L, Aydogmus S, Sabuncuoğlu M, Bilgin E, Duymus TM. Effects of psychological factors on the clinical outcomes of fifth metacarpal neck fractures and their relation to injury etiology. Ulus Travma Acil Cerrahi Derg 2019; 25:403-9. English. doi: 10.5505/tjtes.2018.93928.
  • Kart H, Akça E. Do patients with dominant-side distal radius fractures have greater psychological distress than those with nondominant-side fractures? Clin Orthop Relat Res 2025; 483:279-85. doi: 10.1097/CORR.0000000000003244.
  • Wormald J, Claireaux HA, Gardiner MD, Jain A, Furniss D, Costa ML. Management of extra-articular fractures of the fifth metacarpal: Operative vs. Non-operative Treatment (FORTE) – A systematic review and meta-analysis. JPRAS Open 2019; 20:59-71. doi: 10.1016/j.jpra.2019.02.001.
There are 22 citations in total.

Details

Primary Language English
Subjects Surgery (Other)
Journal Section Research Article
Authors

Ufuk Arzu 0000-0002-6371-2211

Veysel Burak Özmusul 0009-0007-5588-2628

Dursun Artvin 0000-0001-9489-7979

Serdar Orhan 0000-0002-1358-5613

Batuhan Gencer 0000-0003-0041-7378

Deniz Gülabi 0000-0002-4131-7536

Submission Date July 8, 2025
Acceptance Date November 21, 2025
Publication Date January 28, 2026
Published in Issue Year 2026 Volume: 39 Issue: 1

Cite

APA Arzu, U., Özmusul, V. B., Artvin, D., … Orhan, S. (2026). Multiple metacarpal fractures: Is it possible to achieve satisfactory outcomes after conservative treatment? Marmara Medical Journal, 39(1), 39-45. https://doi.org/10.5472/marumj.1873034
AMA Arzu U, Özmusul VB, Artvin D, Orhan S, Gencer B, Gülabi D. Multiple metacarpal fractures: Is it possible to achieve satisfactory outcomes after conservative treatment? Marmara Med J. January 2026;39(1):39-45. doi:10.5472/marumj.1873034
Chicago Arzu, Ufuk, Veysel Burak Özmusul, Dursun Artvin, Serdar Orhan, Batuhan Gencer, and Deniz Gülabi. “Multiple Metacarpal Fractures: Is It Possible to Achieve Satisfactory Outcomes After Conservative Treatment?”. Marmara Medical Journal 39, no. 1 (January 2026): 39-45. https://doi.org/10.5472/marumj.1873034.
EndNote Arzu U, Özmusul VB, Artvin D, Orhan S, Gencer B, Gülabi D (January 1, 2026) Multiple metacarpal fractures: Is it possible to achieve satisfactory outcomes after conservative treatment? Marmara Medical Journal 39 1 39–45.
IEEE U. Arzu, V. B. Özmusul, D. Artvin, S. Orhan, B. Gencer, and D. Gülabi, “Multiple metacarpal fractures: Is it possible to achieve satisfactory outcomes after conservative treatment?”, Marmara Med J, vol. 39, no. 1, pp. 39–45, 2026, doi: 10.5472/marumj.1873034.
ISNAD Arzu, Ufuk et al. “Multiple Metacarpal Fractures: Is It Possible to Achieve Satisfactory Outcomes After Conservative Treatment?”. Marmara Medical Journal 39/1 (January2026), 39-45. https://doi.org/10.5472/marumj.1873034.
JAMA Arzu U, Özmusul VB, Artvin D, Orhan S, Gencer B, Gülabi D. Multiple metacarpal fractures: Is it possible to achieve satisfactory outcomes after conservative treatment? Marmara Med J. 2026;39:39–45.
MLA Arzu, Ufuk et al. “Multiple Metacarpal Fractures: Is It Possible to Achieve Satisfactory Outcomes After Conservative Treatment?”. Marmara Medical Journal, vol. 39, no. 1, 2026, pp. 39-45, doi:10.5472/marumj.1873034.
Vancouver Arzu U, Özmusul VB, Artvin D, Orhan S, Gencer B, Gülabi D. Multiple metacarpal fractures: Is it possible to achieve satisfactory outcomes after conservative treatment? Marmara Med J. 2026;39(1):39-45.