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Background: Results of recent studies show that spiral and oblique metacarpal fractures may be successfully treated with early mobilization protocol without immobilization at all. The essence of this theory is that most of hand fractures heal good and that finger movement does not disturb healing conditions.

The objective of this study was assessment of outcomes of the treatment of finger and metacarpal fractures by early mobilization and without any immobilization.

Methods: 34 patients, 24 men (70%) and 10 women (30%) at a mean age of 38 years, with 24 finger fractures and 12 metacarpal fractures, were treated according to early active motion protocol without immobilization. The patients were reviewed weekly for 2 weeks, at 4 weeks when the treatment was completed, and finally at a mean of 12 months.

Results: All 34 patients achieved painless movement of the affected fingers or fingers representative for broken metacarpal bone. Four patients with finger fractures had incomplete AROM. The total grip strength was a mean of 43 kG in the finger fractures group and 45 kG in the metacarpal fractures group. The DASH score was a mean of 8 points in patients with finger fractures and 4 points in patients with metacarpal fractures. All fractures united. Two patients with finger fractures were withdrawn from the trail due to secondary displacement diagnosed at 2 weeks.

Conclusion: Results of this study demonstrate that treatment of stable fractures of the metacarpal bones and phalanges according to presented protocol is safe, well tolerated by the patients and yields good outcomes.