Hand therapy management of metacarpal fractures: an evidence-based patient pathway

Abstract

Introduction

Metacarpal fracture injuries are commonly referred to hand therapy departments, and may account for up to 40% of all hand fractures. These fractures are managed with either a surgical or non-surgical approach depending on their location and stability. Evidence for the effective therapy management of these fractures is sparse, varied and of poor quality and does not provide a ‘gold standard’ therapeutic treatment approach.

Methods

A literature review was performed to develop an evidence-based patient pathway that accounts for the location and stability of a fracture, minimizes the risks associated with metacarpal fractures and prevents secondary complications from developing.

Results

An evidence-based patient pathway for metacarpal fractures is presented that prevents unnecessary immobilization of unaffected joints and facilitates timely return to function.

Conclusion

The hand therapy management of metacarpal fracture pathway accounts for the location of the fracture, stability and surgical or non-surgical management based on best available evidence. It is recommended that the patient pathway be evaluated against functional outcome measures to ensure patients achieve optimal results.