From the Guidelines
A PIP finger joint avulsion fracture typically requires treatment with a finger splint and buddy taping to balance the need for immobilization and prevention of joint stiffness. The initial management should include immobilization of the affected finger with a dorsal aluminum splint in slight flexion (approximately 15-30 degrees) for about 3-4 weeks, depending on the severity of the fracture, as suggested by general medical knowledge and practices 1. After this initial period of rigid immobilization, buddy taping the injured finger to an adjacent healthy finger provides support while allowing controlled movement, which helps prevent stiffness. This buddy taping should continue for an additional 2-3 weeks as the fracture heals. Ice application for 15-20 minutes several times daily and elevation of the hand above heart level during the first few days help reduce swelling and pain. Over-the-counter pain medications like acetaminophen or ibuprofen can manage discomfort. The use of splints in first aid settings is supported by evidence to reduce pain and prevent further injury, although there's no clear benefit demonstrated for fracture splinting in prehospital settings 1. However, the most recent and highest quality study on first aid guidelines does not specifically address the management of PIP finger joint avulsion fractures, but it emphasizes the importance of immobilization and protection from further injury 1. Given the lack of specific evidence on PIP finger joint avulsion fractures in the provided studies, the recommendation is based on general principles of fracture management and the importance of balancing immobilization with controlled movement to prevent stiffness and promote healing. Key points to consider in management include:
- Immobilization with a finger splint for initial healing
- Buddy taping for support and controlled movement
- Pain management with over-the-counter medications
- Reduction of swelling and pain through ice and elevation
- The importance of early protected motion for better functional outcomes.
From the Research
Treatment Options for Pip Finger Joint Avulsion Fracture
- Finger splint and buddy taping are common treatment methods for Pip finger joint avulsion fracture, as seen in studies 2, 3, 4, 5, 6
- The choice of treatment depends on the severity of the injury and the degree of displacement, with non-displaced fractures often treated conservatively and displaced fractures requiring anatomical reduction and surgical fixation 2
- Buddy taping is a useful method for treating finger injuries, but it can be associated with complications such as skin necrosis, infections, and limited joint motion 3
- A study comparing buddy taping and splint immobilization for pediatric finger fractures found that buddy taping was non-inferior to splint immobilization in terms of secondary fracture displacement, and was associated with higher patient comfort and lower cost 4
- Another study found that closed reduction with percutaneous pinning and volar plate arthroplasty had good clinical and functional outcomes for Pip joint fractures and fracture-dislocations, with low complication rates 5
- Extension splinting of palmar plate avulsion injuries of the proximal interphalangeal joint has also been shown to be an effective treatment method, with a high percentage of patients achieving good or excellent results 6
Considerations for Treatment
- The degree of impaction and the stability of the joint are important factors to consider when treating Pip finger joint avulsion fractures 2
- The type of fracture, including palmar and dorsal fractures, should also be taken into account when determining the best course of treatment 2
- Patient comfort and cost are important considerations when choosing a treatment method, with buddy taping often being a more comfortable and cost-effective option 4
- The risk of complications, such as skin necrosis and infections, should also be considered when using buddy taping as a treatment method 3