Conservative management of spiral/long oblique fractures of the shaft of the metacarpal almost always results in shortening and hence these fractures have the reputation of ending up with an extension lag and reduced grip strength. In a prospective study, 42 patients with 54 fractures were treated with a palmar wrist splint and immediate mobilisation of all finger joints. All fractures united. Extension lag of fractured fingers was initially seen in all fingers, but eventually recovered. Grip strength progressively increased to reach a mean of 94% of the contralateral hand by 1 year after injury.



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