From the Guidelines
A non-displaced volar 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 study by the American College of Foot and Ankle Surgeons, which although focused on heel pain, provides relevant guidance on the treatment of non-displaced fractures 1. The treatment plan should include:
- Immobilization of the finger in a functional position using an aluminum or prefabricated splint for 3-4 weeks
- Buddy taping the injured finger to an adjacent stable finger to provide additional support while allowing some movement
- Elevation of the hand and application of ice for the first 48-72 hours to reduce swelling
- Over-the-counter pain medications like acetaminophen or ibuprofen as needed for pain control
- Active range of motion exercises after 2 weeks to prevent stiffness, avoiding heavy lifting or gripping for 6 weeks
- Follow-up X-rays at 2-3 weeks to ensure proper healing and alignment
The conservative approach is preferred because non-displaced fractures maintain good bone alignment, and the middle phalanx has an excellent blood supply, promoting healing. However, if pain persists beyond expected timeframes or if function doesn't improve, further evaluation may be necessary to rule out complications. It's essential to note that the study by the American College of Foot and Ankle Surgeons, although not directly focused on finger fractures, provides a relevant principle for the treatment of non-displaced fractures 1.