ECRB avulsion fracture therapy management: Case report

Abstract

Avulsion fractures at the base of the second and third metacarpals are very rare, and there is no evidence in the literature for post-surgical therapy management. The purpose of this study was to identify a treatment protocol for post-surgical management of an extensor carpi radialis brevis (ECRB) avulsion fracture. The patient had a fabricated volar wrist splint with 30 degrees of wrist extension and 60 to 70 degrees of MCP flexion. At 4 weeks, the patient progressed to ROM outside of the splint. At 6 weeks, PROM was completed, and splint use was discontinued. At 8 weeks, the patient began progressive strengthening. Following therapy management, the patient achieved near normal range of motion, was pain-free, and had a functional wrist based on the Quick Disabilities of the Arm, Shoulder, and Hand score. Patients with an ECRB avulsion fracture managed with surgery should be splinted post-operatively and progressed through a therapy protocol to monitor both bone healing and the response of the tendon.