Nonsurgical Treatment Versus Surgical Treatment in Displaced Metacarpal Spiral Fractures: Extended 4.5-Year Follow-Up of a Previously Randomized Controlled Trial.

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Résumé de l'étude

This study represents an extended follow-up of a previously completed randomized controlled noninferiority trial. Of the 42 patients originally randomized, 35 patients attended extended follow-up at a mean of 4.5 years (range 3.1–6.6 years) after injury. One patient was excluded due to loss of contralateral hand function, resulting in 34 patients included in the final analysis, with 17 patients treated nonsurgically and 17 patients treated surgically. The primary outcome of interest was grip strength of the injured hand relative to the uninjured hand, reported with and without adjustment for hand dominance. Secondary outcomes included Disabilities of the Arm, Shoulder, and Hand (DASH) score, finger range of motion, rotational deformity, flexion and extension deficits, patient-rated pain, and complications, including revision surgery. Outcomes were assessed at the extended follow-up visit only. Overall, the results of the study showed that nonsurgical treatment with early unrestricted mobilization remained noninferior to surgical fixation for grip strength at the follow-up, with no clinically meaningful differences in functional or patient-reported outcomes between groups.