From the Guidelines
A non-displaced fracture of the middle phalanx of the long finger should be treated with simple immobilization, as this approach is appropriate for small, nonarticular, or minimally displaced fractures. This recommendation is based on the principles outlined in the study by the American College of Foot and Ankle Surgeons, although it focuses on heel pain, the general approach to managing non-displaced fractures can be applied to other areas, including the hand 1.
When managing a non-displaced fracture of the middle phalanx, the goal is to immobilize the affected area to allow for proper healing while minimizing complications and promoting the return of function.
- Immobilization can be achieved with a custom-fitted aluminum splint or a prefabricated finger splint.
- The splint should be designed to immobilize the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints, allowing the metacarpophalangeal (MCP) joint to move freely.
- The duration of immobilization typically ranges from 3 to 4 weeks, during which time the finger should be kept in a functional position, with slight flexion at the joints.
- Pain management is crucial and can be achieved with over-the-counter medications such as acetaminophen or ibuprofen, taken as needed for the first few days.
- Additional measures to reduce swelling include applying ice for 15-20 minutes several times a day and elevating the hand above heart level.
- Follow-up with a hand specialist or orthopedist within 7-10 days is essential to assess the healing process with X-rays.
- After the immobilization period, gentle range-of-motion exercises should be initiated to prevent stiffness, gradually increasing in intensity over 2-3 weeks.
This approach prioritizes the reduction of morbidity, mortality, and improvement in quality of life by promoting proper healing, minimizing the risk of complications, and facilitating the return of hand function. Although the study 1 does not directly address fractures of the middle phalanx, the principles of managing non-displaced fractures can be broadly applied, emphasizing the importance of immobilization and supportive care in the treatment plan.