How long should a finger splint be worn for a non-displaced fracture of the proximal phalanx?

Duration of Finger Splint for Non-Displaced Proximal Phalanx Fracture

A finger splint for a non-displaced fracture of the proximal phalanx should be worn for 4-6 weeks to ensure proper healing while maintaining function. 1

Treatment Approach

Initial Management

• Non-displaced proximal phalanx fractures can be effectively treated with conservative management using appropriate splinting techniques 1
• The goal of treatment is to achieve bone healing while simultaneously maintaining joint mobility to prevent stiffness 2

Splinting Duration and Technique

• Standard splinting duration for proximal phalanx fractures is 4-6 weeks 1
• The splint should immobilize the fracture site while allowing for controlled motion of unaffected joints when possible 3
• For proximal phalanx fractures specifically:
  • A custom-molded thermoplastic splint that allows motion of the interphalangeal joints while stabilizing the fracture is recommended 3
  • Buddy splinting can be used for fractures with minimal angulation (less than 10 degrees) 1

Functional Treatment Considerations

• Dynamic or functional treatment approaches that allow some controlled motion while protecting the fracture site have shown excellent results 2
• This approach aims to achieve bone healing and restore mobility simultaneously rather than sequentially 2
• The "intrinsic plus" position (wrist dorsiflexed 30 degrees, metacarpophalangeal joints flexed 70-90 degrees) provides optimal stabilization of proximal phalanx fractures 2

Monitoring and Follow-up

• Radiographic evaluation should be performed at 3 weeks and at the cessation of immobilization to ensure proper healing 4
• Active finger motion exercises should be performed during the recovery period to prevent stiffness 4
• Hand stiffness is one of the most functionally disabling adverse effects of finger fractures and can be difficult to treat after healing 4

Special Considerations

• Fractures with significant angulation (>10 degrees), displacement, or malrotation often require reduction or surgical intervention rather than simple splinting 1
• Compression-type fractures may require different management approaches, as standard traction splinting can lead to tenodesis effect with severe active flexion deficits 5
• In pediatric patients, shorter immobilization periods may be appropriate, with dynamic splinting techniques showing good results with faster restoration of hand function 6

Potential Complications

• Extended immobilization beyond the necessary healing time can lead to joint stiffness and reduced range of motion 2
• Insufficient immobilization may result in delayed healing, malunion, or non-union 1
• Active finger exercises are critical to prevent stiffness while maintaining the stability of the fracture site 4

By following these guidelines for proximal phalanx fracture management, optimal healing and functional outcomes can be achieved while minimizing complications related to prolonged immobilization.