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Treatment of metacarpal and phalangeal fractures in noncompliant patients.

Uncooperative patients are a problem in any practice setting; however, this is particularly true in large urban county hospitals. Treatment of these patients was unsatisfactory unless special measures were undertaken. Behavior characteristics of noncompliant patients must be identified. Prospective identification of these individuals was found to be the key element in successful treatment. Special, heavy duty splints using proper hand posture were found to be most effective. If surgical treatment was required, then rigid fracture fixation was more beneficial than other forms of internal immobilization.