Early motion following metacarpal fractures

Group 1: Immobilisation (control group) All 4 fingers immobilised in a forearm based, thermoplastic splint for 4 weeks post fracture. Range of motion exercises commenced at 4 weeks post fracture. Group 2: Hand-based Regional Immobilisation Injured digit and adjacent border digit immobilised in a hand based, ulnar or radial gutter thermoplastic splint, for 4 weeks post fracture. Digits that are not included in splint commence range of motion exercises on initial patient contact. Range of motion exercises of injured digits commenced at 4 weeks post fracture. Group 3: Early Mobilisation (forearm resting splint) All 4 fingers included in a removable forearm based thermoplastic resting splint. Injured digit taped to adjacent long finger. Splint to be worn full time, removing every 2 hours to complete exercises. Range of motion exercises commenced at initial patient contact (less than 2 weeks). Group 4: Early Mobilisation (hand-based fracture brace) Thermoplastic functional fracture brace is worn until 4 weeks post fracture. Injured and adjacent long finger buddy taped, and commence range of motion exercises from initial patient contact (less than 2 weeks). Exercises completed wearing fracture brace. Patient instructed not to remove brace and not to attempt heavy functional tasks. All groups to receive oedema management, scar management and further treatment techniques as required. Strengthening exercises to be introduced to all groups at 6 weeks post fracture.