From the Guidelines
A non-displaced fracture of the middle phalanx of the long finger should be treated with conservative management, including immobilization with a splint, pain management, and follow-up radiographs to ensure proper healing alignment. The affected finger should be immobilized in a custom-made or pre-fabricated aluminum splint in a functional position (slight flexion at the MCP and PIP joints) for approximately 3-4 weeks, as recommended by recent guidelines 1. The splint should include both the PIP and DIP joints while leaving the MCP joint free if possible. Over-the-counter pain medications such as acetaminophen (500-1000mg every 6 hours as needed) or ibuprofen (400-600mg every 6-8 hours with food) can help manage pain and inflammation. Ice application for 15-20 minutes several times daily during the first 48-72 hours will help reduce swelling, and elevation of the hand above heart level is also recommended. After the immobilization period, gentle range-of-motion exercises should begin to prevent stiffness, gradually increasing in intensity over 2-3 weeks.
Key considerations for treatment include:
- Immobilization to reduce pain and prevent further injury, as supported by the 2024 American Heart Association and American Red Cross guidelines for first aid 1
- Pain management with over-the-counter medications
- Follow-up radiographs at 2-3 weeks to ensure proper healing alignment
- Gentle range-of-motion exercises after immobilization to prevent stiffness
It is essential to note that the evidence from the American College of Foot and Ankle Surgeons 1 is not directly applicable to this specific scenario, as it focuses on heel pain rather than finger fractures. However, the general principle of conservative management for non-displaced fractures is consistent with the recommended approach. The most recent and highest-quality study, the 2024 American Heart Association and American Red Cross guidelines for first aid 1, provides the basis for this recommendation, prioritizing morbidity, mortality, and quality of life as the outcome.