From the Guidelines
Treatment for a mildly displaced oblique fracture of the fourth proximal phalanx typically involves simple immobilization, as surgery is usually reserved for more complex cases. According to the American College of Foot and Ankle Surgeons, simple immobilization is appropriate when fracture fragments are small, nonarticular, or minimally displaced 1. This approach is consistent with the principle of managing fractures with minimal intervention when possible, to reduce the risk of complications and promote healing.
Key considerations in the treatment of this type of fracture include:
- Immobilization to prevent further displacement and promote healing
- Pain management with medications such as acetaminophen or ibuprofen
- Ice application and elevation to reduce swelling
- Early protected range of motion exercises to prevent stiffness
- Follow-up radiographs to ensure proper healing
It is essential to note that the treatment approach may vary depending on the specific characteristics of the fracture, such as the degree of displacement, angulation, and rotational deformity. However, for a mildly displaced oblique fracture of the fourth proximal phalanx, simple immobilization is often the preferred treatment option, as it allows for reliable healing and minimizes the risk of complications 1.
From the Research
Treatment Options for Mildly Displaced Oblique Fracture of the Fourth Proximal Phalanx
- The treatment for a mildly displaced oblique fracture of the fourth proximal phalanx can vary depending on the degree of displacement and the stability of the fracture.
- According to 2, uncomplicated middle and proximal phalanx fractures can be treated with buddy splinting if there is minimal angulation (less than 10 degrees).
- However, larger angulations, displacement, and malrotation often require reduction or surgery 2.
- For transverse and short oblique proximal phalanx fractures, Kirschner wires can be used for treatment 3.
- A stable short oblique transverse shaft fracture can also be managed with an intrinsic plus splint 3.
- Additionally, an isometric traction splint can be a valid treatment option for displaced fractures of the proximal phalanx, but compression type fractures should be excluded 4.
- Conservative management with buddy taping and immediate mobilisation can also be effective for base fractures of the proximal phalanx, as seen in 5.
- Closed reduction and rigid fixation using a reversed extension splint can also be used to treat dorsally angulated proximal phalanx fractures 6.