From the Guidelines
A minor tuft injury to the distal phalanx of the left index finger cannot be ruled out despite the X-ray showing no displaced fracture, and conservative treatment is recommended. The X-ray findings are consistent with the possibility of a minor tuft injury, which may not be visible on radiographs 1. According to the American College of Radiology, radiographs are usually sufficient for the evaluation of osseous injuries, but may not detect all types of fractures, especially those that are non-displaced or involve the distal phalanx 1.
Given the symptoms and X-ray findings, it is essential to prioritize conservative treatment to promote healing and prevent further injury. This includes:
- Resting the finger and protecting it from further injury by buddy-taping it to an adjacent finger using medical tape with a thin padding between the fingers
- Applying ice for 15-20 minutes several times daily for the first 48 hours to reduce swelling
- Taking over-the-counter pain relievers like acetaminophen (Tylenol) 500-1000mg every 6 hours or ibuprofen (Advil, Motrin) 400-600mg every 6-8 hours as needed for pain
- Keeping the finger elevated when possible
It is crucial to monitor symptoms and seek medical attention if there is increasing pain, numbness, color changes, or if symptoms do not improve within 7-10 days 1. Tuft injuries can cause significant pain and tenderness, but most heal well with conservative treatment within 3-6 weeks, though complete healing may take longer.
From the Research
X-ray Findings and Tuft Injuries
- The X-ray findings of no displaced fracture do not necessarily rule out the presence of a minor tuft (distal phalangeal) injury in the left index finger, as some injuries may not be visible on X-ray [ 2 ].
- A study on traumatic finger injuries highlights the importance of accurate diagnosis and the potential for complications if injuries are not properly identified [ 2 ].
Correlation with Symptoms
- The presence of symptoms in the area of the left index finger may be correlated with a minor tuft injury, even if the X-ray findings do not show a displaced fracture [ 3 ].
- A study on postsplinting x-rays of nondisplaced hand, wrist, ankle, and foot fractures found that such x-rays are often unnecessary and do not change treatment management [ 3 ].
Tuft Fractures and Treatment
- Tuft fractures, including those in the distal phalangeal area, can be treated with various methods, including fixation using a hypodermic needle [ 4 ].
- A study on the treatment of open, unstable tuft fractures in toddlers and preschool-aged children found that fixation using a 25-gauge hypodermic needle can achieve good cosmetic and functional results [ 4 ].