Functional Metacarpal Splint
(Redirected from Functional metacarpal splint)
Other Names
- Functional Metacarpal Splint (FMS)
- Metacarpal Mitt Splint
- Clamshell Splint
- Boxer's Splint
Background
- This page describes the so-called functional metacarpal splint
- This is a U-shaped splint that covers the hand/ metacarpals only
- The advantage is that the wrist, PIP, and DIP joints are left free while still immobilizing the metacarpals
Indications
- Boxers Fracture
- When compared to ulnar gutter splint, the FMS yielded similar long term outcomes ulnar gutter splint[1]
- Metacarpal Fracture
Contraindications
- Absolute contraindications
- None
- Relative contraindications
- Open fractures
- Injuries with neurovascular compromise
Procedure
Equipment
- See: Splinting Materials
Preparation
- Measure splint material
- Measure from the thenar eminence, 1st metacarpal head
- Wrap around ulnar hand and back up the other side to the 1st metacarpal head
- You will need 8-10 layers
Technique
- Patient position
- Wrist is in a neutral position during the procedure
- None of the joints will be immobilized
- Stockinette
- Optional given small size of splint
- Cast padding/ web roll
- Apply covering entire volar/dorsal hand
- Do not cover the MCP joint or wrist joint
- Create a whole for the thumb to protrude through
- Plaster of paris
- Apply on the volar surface starting at the thenar eminence and 1st metacarpal head
- Wrap around the ulnar hand and back up to the metacarpal head on the dorsal side
- Apply extra cast padding
- Fold the stockinette over if used
- Apply elastic wrap over the splint and web roll
- Make a whole for the thumb
- Smooth out the splinting material
- Confirm distal neurovascular status
Aftercare
- Try to elevate extremity for the first few days to prevent more swelling
- Advise patient to keep cast or splint clean and dry
- Do not insert objects into splint/ cast
- Monitor for complications (worsening pain, paresthesia/ numbness, color changes)
- Seek further care if unable to control pain at home
Complications
- Plaster burn/ thermal injury
- Pressure sores
- Nerve palsy
- Vascular compromise
- Splint dermatitis
- Permanent joint stiffness
See Also
References
- ↑ 1.0 1.1 Kaynak, Gokhan, et al. "Comparison of functional metacarpal splint and ulnar gutter splint in the treatment of fifth metacarpal neck fractures: a prospective comparative study." BMC Musculoskeletal Disorders 20 (2019): 1-10.
- ↑ The Metacarpal Mitt Splint for 2nd-5th Metacarpal Fractures: A Prospective Case Series Daniel Yang Hong, MD, Chimere O Ezuma, BA, Peter C Noback, MD, Liana J Tedesco, MD and Robert J Strauch, MD, Columbia University Medical Center, New York, NY
Created by:
John Kiel on 22 June 2023 12:19:40
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Last edited:
24 June 2023 15:49:48
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