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

Gülke, J.; Leopold, Barbara; Grözinger, Daniel; Drews, B.; Paschke, Stephan; Wachter, N. J.

doi:10.1016/j.jht.2017.02.005

Cited by 12 publications

(24 citation statements)

References 26 publications

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“…A further eight full-text articles were excluded with detailed reasons for exclusion in Appendix Table 1-A2. The three studies included in the review were a RCT by Gülke et al (2018) and two observational studies by Gamble et al (2015) and Al-Qattan (2008). The RCT had a high GRADE rating because of the study design, clear reporting and no serious inconsistencies and study limitations.…”

Section: Resultsmentioning

confidence: 99%

Hand rehabilitation programmes for second to fifth metacarpal fractures: A systematic literature review

Keller

Barnes

Brandt

et al. 2021

South African Journal of Physiotherapy

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Background: Metacarpal fractures, one of the most prevalent upper limb fractures, account for 10% of all bony injuries.Objective: Our systematic review aimed to review, appraise and collate available evidence on hand rehabilitation programmes for the management of second to fifth metacarpal fractures in an adult human population after conservative and surgical management. Since 2008, no review on a similar topic has been performed, thus informing clinical practice for physiotherapists and occupational therapists.Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) principles guided the reporting. Experimental, quasi-experimental, cohort and case–control studies between January 2008 and September 2018 were included. Searches were conducted on Medline, Academic Search Ultimate, CINAHL, CAB Abstracts, Health Source – Consumer Edition, Health Source: Nursing/Academic Edition, SPORTDiscus, Africa-Wide Information and MasterFILE Premier, Web-of-Science and Scopus. Screening, selection, appraisal and data extraction were independently performed by two reviewers. No meta-analysis was performed.Results: A total of 1015 sources were identified, 525 duplicates removed and 514 excluded. Three articles were included in the final data extraction: one randomised controlled trial (RCT) and two observational studies.Conclusion: Limited evidence is available that a well-designed, well-implemented home-based exercise programme results in statistically significant improved hand function (p ˂ 0.0001) and digital total active motion (TAM) (p = 0.013) compared with traditional physiotherapy (PT) post-surgically.Clinical implications: Our study contributes to the knowledge base of hand rehabilitation after an individual sustained a second to fifth metacarpal fracture. The authors identified a gap where future studies should further investigate the effect of hand rehabilitation after conservative and surgical management.

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Section: Resultsmentioning

confidence: 99%

Hand rehabilitation programmes for second to fifth metacarpal fractures: A systematic literature review

Keller

Barnes

Brandt

et al. 2021

South African Journal of Physiotherapy

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“…The ROM measured at three months improved to 245° total active motion (TAM) for the PT group and 256° TAM for the home exercise group out of a normal digit range of motion of 270°. The findings suggested that a well-developed and instructed home exercise program as post-operative management for second to fifth (non-thumb) metacarpal fractures can be as effective as traditional PT rehabilitation [8].…”

Section: Fifth Metacarpal Fractures Have Left Individuals With Functimentioning

confidence: 96%

“…Management of second to fifth metacarpal fractures varies in literature and is dependent on, but not limited to, the follow factors: surgical or conservative medical management, area of fracture, angulation, rotation and shortening of the metacarpal bone. Literature relating to hand rehabilitation after surgical and conventional management will be provided [6][7][8][9][10].…”

Section: Fifth Metacarpal Fractures Have Left Individuals With Functimentioning

confidence: 99%

“…In a prospective cohort randomized control trial (RCT) the effect of a traditional physiotherapy (PT) program compared to a home exercise program for non-thumb (second to fifth) metacarpal fractures managed with open reduction internal fixation procedures, was measured [8]. The follow up assessments at two weeks postoperatively, demonstrated a severe loss of digital ROM in both groups.…”

Section: Fifth Metacarpal Fractures Have Left Individuals With Functimentioning

confidence: 99%

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Hand Rehabilitation Programs Used for Second to Fifth Metacarpal Fractures: A Systematic Literature Review Protocol

Keller

Barnes

Brandt

2020

Preprint

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BackgroundMetacarpal fractures have an incidence rate of 13.6 per 100000, affects males more than females and accounts for 33% of all hand fractures. No evidence-based rehabilitation program exists for second to fifth metacarpal fractures potentially causing poor health related quality of life, decrease hand function and disability.MethodsExperimental study designs, quasi-experimental, cohort studies and case control studies for the last ten years from January 2008 to September 2018 with English as a language restriction will be included. Sources investigating hand rehabilitation, immobilization, splinting and home programs after surgical and conservative management for second to fifth metacarpal fractures, will be included. MEDLINE, Academic Search Ultimate, CINAHL, CAB Abstracts, Health Source - Consumer Edition, Health Source: Nursing/Academic Edition, SPORTDiscus, Africa-Wide Information, MasterFILE Premier, Google Scholar and other grey literature will be searched. Two independent reviewers will independently conduct the study selection, methodology quality assessment and extraction of data. Findings will be pooled, meta-analysis performed, Summary of Findings provided according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis if deemed appropriate.DiscussionIt is imperative to implement effective rehabilitation to prevent poor health related quality of life, decrease hand function and disability. In this systematic literature review, we will determine the existing evidence on hand rehabilitation programs used after post-surgical and conservative management for 20 to 59-year-old humans who sustained a single or multiple second to fifth metacarpal fracture.

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“…Eighty-six per cent of the patients had excellent results. Gülke et al. (2018), in a prospective clinical trial, showed that home exercises yielded equally good results as traditional hand therapy in the clinic.…”

Section: Postoperative Motion and Therapymentioning

confidence: 97%

Current methods, outcomes and challenges for the treatment of hand fractures

Boeckstyns¹

2020

J Hand Surg Eur Vol

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In treating hand fractures, we have to make a proper decision about conservative treatment versus surgical intervention and decide on individual surgical methods. This article reviews recent publications, technical advances, and outcome measures in treating metacarpal fractures, phalangeal fractures, complex fractures of the proximal interphalangeal joints, bony mallet fingers, and fractures of the thumb. My personal preferences and considerations are presented. At the end, the current challenges that hand surgeons are facing in treating frequent phalangeal and metacarpal fractures are discussed.

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

Cited by 12 publications

References 26 publications

Hand rehabilitation programmes for second to fifth metacarpal fractures: A systematic literature review

Hand rehabilitation programmes for second to fifth metacarpal fractures: A systematic literature review

Hand Rehabilitation Programs Used for Second to Fifth Metacarpal Fractures: A Systematic Literature Review Protocol

Current methods, outcomes and challenges for the treatment of hand fractures

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