Patient Education for Finger Fracture
All patients with finger fractures must begin active finger motion exercises of all uninjured joints within 3 days of injury to prevent debilitating stiffness, which is one of the most functionally disabling complications and becomes extremely difficult to treat after fracture healing. 1
Immediate Education Points at First Encounter
Critical Movement Instructions
- Instruct the patient to move all non-immobilized fingers regularly and through complete range of motion starting immediately 2
- Emphasize that finger stiffness can develop even in unfractured fingers, especially with associated crush injuries 1
- Explain that finger motion does not adversely affect an adequately stabilized fracture regarding reduction or healing 2
- This intervention is extremely cost-effective, requires no pharmaceutical intervention or additional visits, but provides significant impact on patient outcome 2
Pain Management Education
- Provide multimodal analgesia immediately, including acetaminophen 1
- Explain that unremitting pain during follow-up warrants immediate reevaluation for complications 2, 1
- Educate that pain, swelling, and apprehension can contribute to finger stiffness if motion is not maintained 2
Splinting and Activity Modification
Immobilization Guidelines
- Explain the specific immobilization requirements based on fracture type and location 3
- For distal phalanx fractures: splinting of the distal interphalangeal joint for 4-6 weeks 3
- For mallet finger (dorsal avulsion fractures): strict splint immobilization for 8 weeks with no interruptions 3
- Emphasize that splints or casts should not obstruct movement of uninjured fingers 2
Activity Restrictions
- Discuss activity modification appropriate to the injury pattern 2
- Explain when to seek immediate care: increasing pallor, decreased sensation, severe unrelenting pain, or decreased perfusion 4
Age-Specific Considerations for Patients Over 50
In patients over 50 years, educate that a finger fracture may represent an underlying fragility fracture requiring comprehensive osteoporosis evaluation and treatment. 1
Osteoporosis Education
- Explain the burden of disease and that this fracture indicates increased risk of subsequent hip or vertebral fractures 2, 1
- Discuss that systematic fracture risk assessment will be performed 2
- Educate about the importance of adequate calcium and vitamin D intake 2
- Emphasize stopping smoking and limiting alcohol intake 2
- Explain that pharmacological treatment may be initiated even before bone density testing in typical fragility fracture patterns 1
Fall Prevention
- Implement fall prevention education including balance training to prevent subsequent fractures 1
- Discuss multidimensional fall prevention strategies 2
Follow-Up and Adherence Education
Expected Timeline
- Explain the expected healing timeline based on fracture location 3
- Discuss when follow-up appointments are necessary 1
- For elderly patients, emphasize systematic follow-up for osteoporosis treatment adherence 1
Warning Signs Requiring Immediate Attention
- Increasing pain despite appropriate analgesia 2, 1
- Decreased sensation or numbness 4
- Color changes (pallor or cyanosis) 4
- Inability to move fingers as instructed 2
- Signs of infection if there was an open wound 5
Rehabilitation Education
Home Exercise Program
- A directed home exercise program is an option for patients prescribed therapy after finger fracture 2
- Explain that aggressive finger motion exercises for all non-immobilized digits should begin from day one 1
- Emphasize that failure to maintain motion can result in stiffness requiring multiple therapy visits and possibly additional surgical intervention 2
Long-Term Functional Goals
- Discuss realistic expectations for return to normal activities 2
- Explain that treatment should be tailored to functional demands and patient needs 2
Common Pitfalls to Avoid
Never ignore uninjured fingers—stiffness can develop in unfractured fingers if motion is not maintained from the outset. 1
- Do not wait for pain to completely resolve before beginning finger motion exercises 2
- In elderly patients, do not fail to address underlying osteoporosis, which leaves patients at increased risk of subsequent fractures 1
- Do not allow splints or casts to restrict motion of uninjured joints 2
Duration of Treatment Education
- Explain that therapy duration depends on fracture type, age, comorbidities, and functional requirements 2
- For patients with complications like finger stiffness or complex regional pain syndrome, supervised therapy may be necessary 2
- Emphasize regular monitoring for tolerance and adherence to any prescribed treatments 2