From the Guidelines
The patient's mildly displaced avulsion fracture from the dorsal base of the distal phalynx of the fifth digit can be managed with simple immobilization, given the small and minimally displaced nature of the fracture fragments, as suggested by the American College of Foot and Ankle Surgeons 1. The patient has already taken a proactive step by purchasing a medical-grade splint for immobilization, which is appropriate for this type of fracture. Key aspects of management include:
- Immobilization: The patient's use of a metal, medical-grade splint on the pinky is a good start, and this should be continued for a period of 3-6 weeks to allow for proper healing.
- Pain management: Although the patient has not taken any OTC meds, consideration should be given to using NSAIDs like ibuprofen (400-600mg every 6-8 hours) or naproxen (250-500mg twice daily) for 1-2 weeks to manage pain and inflammation, as part of a broader approach to pain management.
- Monitoring: Regular follow-up appointments are necessary to monitor the healing progress and adjust the treatment plan as needed.
- Rehabilitation: After the immobilization period, the patient should begin gentle range-of-motion exercises, progressing to strengthening exercises to regain full function of the hand, particularly focusing on the affected pinky and the medial side of the hand where weakness and fatigue are reported. Given the non-weight-bearing nature of this fracture and its location, the risk of long-term complications is lower, but careful management is still necessary to ensure proper healing and prevent future issues.
From the Research
Avulsion Fracture Treatment and Management
The patient's condition, an avulsion fracture from the dorsal base of the distal phalynx of the fifth digit, requires appropriate treatment and management.
- The use of a metal, medical grade splint to support the affected area is a common approach for managing avulsion fractures, as seen in the patient's self-care initiative.
- However, the provided studies do not directly address the treatment of avulsion fractures of the distal phalynx.
Relevant Studies
- A study on tibial spine avulsion fractures 2 discusses the classification and treatment of these fractures, including immobilization, closed reduction, and arthroscopic or open reduction and fixation.
- Another study on anterior-superior iliac spine avulsion fractures 3 compares non-surgical and surgical treatment using absorbable screws, finding that absorbable screws can be safely used and result in shorter recovery times and fewer complications.
- A case series on manual physical therapy following immobilization for stable ankle fractures 4 demonstrates the effectiveness of impairment-based manual physical therapy in improving function and reducing pain.
- A study on the management of type II avulsion fractures of the tibial intercondylar eminence in children 5 compares arthroscopic suture fixation with conservative immobilization, finding superior clinical outcomes with the surgical approach.
Considerations for Treatment
- The patient's symptoms, including pain, numbness, weakness, and fatigue, should be taken into account when developing a treatment plan.
- The use of a splint, as initiated by the patient, may be beneficial in supporting the affected area and reducing discomfort.
- Further evaluation and consultation with an orthopedic specialist or other relevant healthcare professionals may be necessary to determine the best course of treatment for the patient's specific condition.