Active training without surgery is as useful as surgery and plastering for metatarsal fractures

– The study showed that results were just as good with active training without surgery as with surgery/casting. Among patients treated with exercise, fractures healed well and sick leave time was significantly shorter. Patients became less stiff and recovered more quickly. The treatment method also did not affect the patient’s hand function, pain or satisfaction, says Fredrik Peronsson, an ST in hand surgery at the Academic Hospital and researcher at Uppsala University.

Metatarsal fractures, otherwise called metatarsal fractures, are very common injuries in the emergency or emergency department. Fractures often occur due to falls or blunt force when the hand strikes a hard object, but also due to sports injuries. It can also occur in connection with car accidents and blast or gunshot injuries. Fractures occur at all ages and affect both sexes, but are most common in young adults of working age.

In the current study, a relatively new exercise-oriented treatment modality without surgery was compared with conventional treatment, meaning that where significant misalignment is present, surgery and repair with screws are performed, usually completed with a shorter time in plaster. The purpose was to check whether the new treatment produced results no worse than the old method. The patients were randomly divided into two groups who received treatment. Patients in the surgery group were treated with gypsum for two weeks.

All patients in the training group were required to begin hand movement training as soon as they were included in the study, within ten days after injury. They were allowed to load the entire hand without restriction. The training involved actively stretching the fingers and flexing the hand at least 25 times a day, spread over five occasions during the day, using the muscular strength of the affected hand. In addition, the patients were allowed to use their hands completely freely, explains Fredrik Beronson.

We hope that, in the future, more patients will be treated with immediate mobilization after an oblique fracture through the metatarsal shaft of the hand. It can significantly reduce risks related to surgery and short sick leave, without impairing treatment results. He concludes that fewer surgeries for metatarsal fractures will also free up more resources to operate on those injuries as we know that surgery is necessary to achieve a good outcome.

Facts about the study

• He drove from the academic hospital. During the years 2017-2020, patients were included in the Academic Hospital, between March 2019 and May 2020 also in the Fallo Hospital.
• All patients injured themselves for a maximum of ten days prior to receiving treatment in the framework of the study.
• Everyone who participated in the study had a misalignment of the index, long, ring, or pinky finger of at least 2 millimeters during the X-ray examination or a rotational misalignment detected during the physical examination. Fractures of the metatarsal bones of the thumb were not included in the study.
• The patients also had normal pre-fracture hand function and the ability to perform hand training.

Read more about the study here.

For more information/interview contact:
Fredrik Peronsson, ST doctor in hand surgery at Academic Hospital and doctoral student at Uppsala University;
018-617 15 45
[email protected]