What is the initial management for a non-displaced 5th proximal phalanx fracture in an 11-year-old boy?

From the Guidelines

The initial management for a non-displaced 5th proximal phalanx fracture in an 11-year-old boy should involve simple immobilization, as surgery is not typically required for non-displaced fractures with small fragments 1. When managing this type of fracture, it's essential to consider the following key points:

• Immobilization can be achieved with buddy taping and a protective splint to maintain proper alignment and allow for some mobility.
• The injured finger should be taped to the adjacent ring finger using cloth tape with gauze between the fingers to prevent skin maceration.
• A dorsal aluminum splint should be applied with the metacarpophalangeal (MCP) joint flexed at 70-90 degrees and the interphalangeal joints in slight flexion (15-20 degrees) for 3-4 weeks.
• Pain management can include acetaminophen or ibuprofen, with ice application and elevation of the hand above heart level to reduce swelling.
• Follow-up should occur within 7-10 days to ensure proper healing, with radiographs to confirm alignment.
• After immobilization, gentle range of motion exercises should be initiated to prevent stiffness, but contact sports should be avoided for 6-8 weeks total to prevent re-injury. Given the non-displaced nature of the fracture and the age of the patient, conservative management with immobilization is the most appropriate initial approach, as it allows for proper healing while minimizing the risk of complications 1.

From the Research

Initial Management for Non-Displaced 5th Proximal Phalanx Fracture

The initial management for a non-displaced 5th proximal phalanx fracture in an 11-year-old boy involves:

• Immobilization to prevent further injury and promote healing
• Splint immobilization is commonly used for non-displaced phalanx fractures 2
• The goal is to achieve bony healing and maintain finger mobility

Treatment Options

Treatment options for non-displaced proximal phalanx fractures include:

• Conservative functional treatment with dynamic splinting and fiberglass casting material 3
• Splinting or casting, with no significant difference in clinical and radiologic outcomes between the two 4
• Immobilization of the wrist and metacarpophalangeal joints to prevent rotational deformity and coronal malalignment 5

Important Considerations

Important considerations in the management of non-displaced proximal phalanx fractures include:

• Regular follow-up to monitor fracture healing and maintain reduction 2
• Early active motion exercises to prevent limitations of mobility and deformities 5, 3
• Accurate anatomical reduction of the fracture to achieve the best results 6