The authors evaluate the outcomes in 7 patients who were treated conservatively for collateral ligament avulsion fractures of the metacarpophalangeal (MCP) joints. There were 9 injured fingers, fracture fragments involved 10% to 25% of the articular surface, and displacement measured between 0 and 2 mm. Treatment was initiated within 2 weeks of injury and entailed finger strapping of the injured digit to the adjacent digit with early motion. At a mean follow-up of 57 months, all but one patient had a full range of finger movement and normal grip strength. The injured MCP joints were stable and pain was negligible in all cases.
Good results following surgery for MCP collateral ligament avulsion fractures have been reported (Shewring and Thomas, JHS Br, 2003). Surgery has been recommended for joint surface involvement greater than approximately 20% and for fragment displacement greater than 2mm. However, there is limited information regarding nonsurgical management of this injury. The results from this study suggest that fractures with up to 25% involvement of the joint surface and displacement of 2 mm or less may be managed conservative. Conservative treatment may be less applicable to larger fractures with displacement on the radial side of the index finger which is subjected to lateral stress during pinch.
Metacarpophalangeal, Joint, Fracture, Conservative, Avulsion