From the Research
Treatment for a hairline fracture of the proximal interphalangeal (PIP) joint of the thumb typically involves immobilization with a thumb spica splint for 3-4 weeks, as this approach prioritizes minimizing morbidity, mortality, and optimizing quality of life by allowing for proper healing and reducing the risk of complications. The splint should keep the thumb in a functional position while allowing the other fingers to move freely. Over-the-counter pain medications such as acetaminophen (500-1000mg every 6 hours, not exceeding 4000mg daily) or NSAIDs like ibuprofen (400-600mg every 6-8 hours with food) can help manage pain and reduce inflammation, as suggested by general medical practice 1, 2, 3, 4.
Key Considerations
- Ice should be applied for 15-20 minutes several times daily during the first 48-72 hours to minimize swelling.
- After the immobilization period, gentle range-of-motion exercises should be started to prevent stiffness and restore function.
- These exercises include carefully bending and straightening the thumb joint several times daily.
- Most hairline fractures heal well with conservative treatment because the PIP joint has good blood supply, as noted in the management of similar injuries 3, 4.
Potential Complications and Further Evaluation
However, if pain persists beyond 6 weeks or if there are signs of joint instability, further medical evaluation is necessary as surgical intervention might be required, emphasizing the importance of careful monitoring and timely intervention to prevent long-term morbidity 3. Complete healing typically occurs within 6-8 weeks, though full strength may take longer to return. The approach to treatment should be guided by the most recent and highest quality evidence available, prioritizing patient outcomes in terms of morbidity, mortality, and quality of life.