From the Research
A Zimmer splint does not need to be worn continuously for a fracture of the tuft of the terminal phalanx. The recommended approach is to wear the splint for comfort during the day, particularly when the finger might be at risk of trauma or when pain is significant, and to remove it during rest periods and at night if comfortable. This approach is supported by the most recent and highest quality study available, which suggests that nonoperative treatment with removable splints can achieve remarkable fracture remodeling and full functional recovery in pediatric phalangeal neck fractures 1.
Key Considerations
- The splint should be worn for approximately 3-4 weeks, or until the pain subsides and the fracture shows signs of healing on follow-up X-rays.
- Tuft fractures are stable injuries that typically heal well without rigid immobilization.
- The primary purpose of splinting is to protect the injured fingertip from further trauma and to reduce pain by limiting movement.
- Complete immobilization can lead to joint stiffness and delayed rehabilitation.
Additional Recommendations
- Alongside splinting, pain management with acetaminophen or NSAIDs like ibuprofen (400-600mg every 6-8 hours) is recommended.
- If there is an associated nail bed injury or open fracture, proper wound care and possibly antibiotics would be necessary.
- Regular gentle range of motion exercises when the splint is removed can help maintain joint mobility and prevent stiffness.
- The most recent study comparing casting versus splinting for nonoperative treatment of pediatric phalangeal neck fractures found no significant difference in radiologic outcomes between the two methods, suggesting that splinting is a viable alternative with added benefits of increased comfort and hygiene 1.