Gokhan SAYER, Mustafa PEHLIVAN, Zeki GUNSOY
Medical Records - 2026;8(1):1748322-1748322
Aim: This study aimed to evaluate the clinical and functional outcomes in cases with a volar angulation of 45 derece or more who were treated conservatively for fifth metacarpal neck fractures. Material and Methods: The study included 49 male patients diagnosed with a fifth metacarpal neck fracture and treated conservatively with a volar angulation greater than 45 derece between September 2021 and September 2024. All patients were treated with an ulnar gutter splint. At the final follow-up, assessments included the Visual Analog Scale (VAS), Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH), Functional Scoring System (FSS), range of motion (ROM) of the metacarpophalangeal (MP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints, and grip strength. Results: The average age of the patients was 33.75 +/- 9.50 years, with a mean follow-up duration of 19.93 +/- 4.31 months. The most common injury mechanism was punching (69.4%), and the right hand was affected in 85.7% of cases. The mean VAS score was 0.12 +/- 0.48, the mean Q-DASH score was 1.48 +/- 2.52, and the mean FSS score was 29.53 +/- 0.98. The average ROM measured was MP: 91.3 +/- 3.8 derece, PIP: 107.6 +/- 5.9 derece, and DIP: 84.6 +/- 5.6 derece. The mean grip strength was 44.18 +/- 7.64 kg. Conclusion: This study demonstrates that for fifth metacarpal neck fractures with an angulation of 45 derece or more, conservative treatment can achieve good functional outcomes and maintain ROM.
