Postoperative treatment of metacarpal fractures—Classical physical therapy compared with a home exercise program

• Published in: Journal of hand therapy Vol. 31; no. 1; pp. 20 - 28
• Main Authors: Gülke, Joachim, MD, Leopold, Barbara, PT, Grözinger, Daniel, MD, Drews, Björn, MD, Paschke, Stephan, MD, Wachter, Nikolaus J., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2018; Elsevier Limited
• Subjects: Fractures; Grip strength; Hand; Home exercise program; Mediocarpal fracture; Metacarpal; Patient satisfaction; Patients; Physical Medicine and Rehabilitation; Physical therapy; Postoperative treatment; Randomization; Rehabilitation; Scars; Surgeons; Surgery; Young adults; Germany; Mediocarpal fracture; Home exercise program; Hand; Physical therapy; Postoperative treatment
• ISSN: 0894-1130; 1545-004X
• DOI: 10.1016/j.jht.2017.02.005

Abstract Study Design Prospective cohort randomized controlled trial. Purpose of the Study Is either a home exercise (HE) program or traditional physical therapy (PT) more effective in the postoperative management of metacarpal fractures? Methods Sixty patients suffering from nonthumb metacarpal fractures who received mobilization-stable open reduction and internal fixation were included. All patients were prospectively randomized into either the PT group or the HE group. Follow-up examinations at 2, 6 and 12 weeks postoperatively. Results After 2 weeks, the range of motion (ROM) in both groups was still severely reduced. Twelve weeks after surgery the ROM improved to 245° (PT) and 256° (HE). Grip strength after 6 weeks was 68% (PT) and 71% (HE) when compared to the non-injured hand, improving to 91% (PT) and 93% (HE) after 12 weeks. Conclusion Study results show that both HE program and traditional PT are effective in the postoperative management of metacarpal fractures. Level of Evidence II.