Outcome of functional treatment with a Lucerne Cast in patients with hand fractures: a retrospective case series

Abstract

Purpose: The purpose of this study was to determine the clinical outcome of patients treated with a functional Lucerne Cast (LuCa) for different types of hand fractures. Static casting has traditionally been the preferred treatment for hand fractures. However, functional casting may lead to good functional outcomes, less stiffness, and earlier return to work.

Methods: A retrospective case series of all consecutive patients with a metacarpal or proximal phalangeal fracture treated with a LuCa between 2018 and 2019 was conducted. A total of 90 patients were included. Clinical data were collected directly from the patient's medical records. Functional outcome was assessed with the Michigan Hand Outcomes Questionnaire (MHQ).

Results: The median MHQ score was 95 (IQR 83-100) with a median follow-up of 23 months. Complications occurred in 7 of 90 patients (8%). Functional impairment occurred in two (2%) patients. Functional impairment was defined as stiffness, persisting rotational deformity, a boutonnière or swanneck deformity. Persisting pain or CRPS occurred in six (7%) patients.

Conclusion: The LuCa shows to be effective in the functional treatment of both metacarpal and proximal phalangeal fractures with excellent patient-reported outcomes but at a relatively high rate of persisting pain.

Keywords: Functional casting; Hand therapy; Lucerne Cast; Metacarpal fractures; Phalangeal fractures.