title: Conservative treatment has comparable outcome with bouquet pinning of little finger metacarpal neck fractures: a multicentre randomized controlled study of 85 patients.
abstract: Current literature gives few guidelines regarding indication for operative treatment of little finger metacarpal neck fractures, and some surgeons choose operative treatment when the palmar angulation exceeds 30°. The objective of this study was to determine whether conservative treatment produces comparable outcomes with bouquet pinning in a randomized, controlled trial. Eighty-five patients with little finger metacarpal neck fractures with ≥30° palmar angulation in the lateral view were included. Patients were randomized to two groups: conservative treatment without reduction of the fracture (43 patients); and closed reduction and bouquet pinning (42 patients). After 1 year, there were no statistical differences between the groups in QuickDASH score, pain, satisfaction, finger range of motion, grip strength, or quality of life. There was a trend versus better satisfaction with hand appearance (p = 0.06), but longer sick leave (p < 0.001) and more complications (p = 0.02) in the operative group.
authors.affiliation: Department of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway Ida.sletten@live.no.
authors.forename: I N
authors.initials: IN
authors.lastname: Sletten
authors.affiliation: Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.
authors.forename: J C
authors.initials: JC
authors.lastname: Hellund
authors.affiliation: Department of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.
authors.forename: B
authors.initials: B
authors.lastname: Olsen
authors.affiliation: Department of Orthopaedic Surgery, Akershus University Hospital, Lørenskog, Norway.
authors.forename: S
authors.initials: S
authors.lastname: Clementsen
authors.affiliation: Division of Neurosciences and Orthopaedics, University Hospital of North Norway, Tromsø, Norway Department of Clinical Medicine, University of Tromsø - Arctic University of Norway, Tromsø, Norway.
authors.forename: H D
authors.initials: HD
authors.lastname: Kvernmo
authors.affiliation: Department of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway Faculty of Medicine, University of Oslo, Blindern, Norway.
authors.forename: L
authors.initials: L
authors.lastname: Nordsletten
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001858:Bone Nails; D002370:Casts, Surgical; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000628:therapy*; D018737:Hand Strength; D006801:Humans; D008297:Male; D050279:Metacarpal Bones / Q000293:injuries*; D008875:Middle Aged; D016059:Range of Motion, Articular; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Metacarpal neck fracture; bouquet pinning; conservative treatment; randomized controlled trial