The authors retrospectively reviewed 19 patients (19 cases) with collateral ligament avulsion fractures from the metacarpal heads. Seven nondisplaced fractures were initially managed with splinting and budding strapping, whereas 12 displaced fractures were treated with screw fixation. The patients were observed for 3 to 12 months postoperatively. Three patients in the splint group developed symptomatic delayed unions and were treated secondarily by screw fixation. All 15 surgical cases healed, but 4 failed to regain full flexion of the metacarpophalangeal joint. The 4 patients managed conservatively demonstrated fracture union and full finger movement.
There is a paucity of information in the English-language literature pertaining to collateral ligament avulsion fractures from the metacarpal heads. The authors of this reported advocate initial surgical treatment of displaced fractures and nonsurgical treatment of nondisplaced fractures. Further study is necessary to determine the better primary treatment approach.
Fracture, Metacarpal, Head, Avulsion, Collateral
J Hand Surg