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Functional cast immobilization of thumb metacarpophalangeal joint injuries

Department of Orthopedic Surgery, Pocono Hospital and Pocono Orthopedic Consultants, East Stroudsburg, Pennsylvania

A prospective study was performed on 40 patients who were treated with a modified thumb spica cast (MTSC) for injuries involving the region of the metacarpophalan geal joint of the thumb. Twenty-seven of these injuries occurred during sports participation. The immobilization consisted of a fiberglass cast which incorporated the thumb in a balanced position and allowed full flexion and extension of the wrist.

Twenty patients had injuries involving the ulnar col lateral ligament (five surgical). Three patients had radial collateral ligament injuries (two surgical). Fourteen pa tients had fractures of the proximal phalanx, including five epiphyseal plate injuries. Two patients had dorsal dislocations and one patient had a metacarpal fracture. One patient with a nondisplaced distal metacarpal frac ture was treated with simple immobilization.

All patients had successful completion of their treat ment within the usual time frame. There was no recur rence or increase in symptomatology during the treat ment. There was no residual discomfort, loss of position or malunion of the fractures treated.

The advantages of the MTSC include improved func tional capabilities during immobilization, good patient acceptance, and no period of limited wrist motion or atrophy of forearm musculature.

Our experience has been that the MTSC has been a reliable form of immobilization for treating injuries of the metacarpophalangeal joint of the thumb.

This article has been cited by other articles:

				A. C. Rettig, R. Ryan, K. D. Shelbourne, J. R. McCarroll, F. Johnson JR, and S. K. Ahlfeld Metacarpal fractures in the athlete Am. J. Sports Med., July 1, 1989; 17(4): 567 - 572. [Abstract] [PDF]