Safety Evaluation of Early Active and Passive Motion Without Immobilization in Metacarpal Fractures

Objective: Early motion after surgical treatment of metacarpal fractures is important to prevent joint motion limitation. Contrarily, the loss of reduction in the fracture line with an early motion negatively affects the results. This study aimed to evaluate the reliability of early active and passive motion without immobilization after surgical treatment and compare the results with the traditional rehabilitation program. Methods: This study included 86 patients who were fixed with miniplate screws. Patients were divided into two groups according to the rehabilitation programs. The first group had immobilization with orthosis and traditional rehabilitation program for 4 weeks, whereas the second group had an early active and passive joint range of motion exercises without immobilization. The first group included 37 males and 16 females with a mean age of 34.92±12.97 years who were followed for an average of 43.19±13.03 months. The second group included 23 males and 16 females with a mean age of 31.82±11.92 years who were followed for an average of 39.05±12.74 months. Results: No significant differences were determined between the groups in terms of age, female-male ratio, time from injury to surgery, follow-up period, fractured extremity, and dominant-non-dominant ratio. Additionally, no significant differences were found between the groups in terms of grip strength and time to return to work at the final follow-up. The total joint range of motion and Quick Disabilities of the Arm, Shoulder, and Hand scores were significantly better in the second than the first group. Union at the fracture line without reduction loss was observed in both groups at the final follow-up. Conclusion: Fixation with miniplate screws provides stable fixation in extra-articular metacarpal fracture. Early active and passive motion without immobilization does not cause complications at the fracture line with this stable fixation. Contrarily, more successful results were obtained than the traditional rehabilitation program in terms of the range of motion and functional results.