How long should a patient with a finger sprain wear a splint?

Duration of Splinting for Finger Sprains

For a finger sprain, wear a splint for 3-4 weeks with radiographic follow-up, then transition to active motion exercises. 1

Initial Splinting Protocol

• Use a rigid finger splint that immobilizes the proximal interphalangeal (PIP) joint while allowing metacarpophalangeal (MCP) joint motion for the first 3-4 weeks 1
• The splint should be padded and comfortably tight but not constrictive—you should be able to slip a finger underneath it 2
• For minor sprains without significant instability, buddy taping to an adjacent finger may be sufficient and allows immediate active motion 1

Duration Guidelines by Severity

• Minor finger sprains: 3-4 weeks of rigid splinting 1
• More severe sprains with significant swelling or instability: up to 6 weeks may be needed, though this is based on extrapolation from similar injuries 3
• Obtain radiographic follow-up at approximately 3 weeks to assess healing and rule out occult fractures 1, 2

Critical Transition to Active Motion

• Begin active finger motion exercises immediately for all unaffected joints to prevent stiffness 1
• When splinting is discontinued at 3-4 weeks, transition to aggressive finger and hand motion exercises 1
• Active motion does not adversely affect adequately stabilized injuries and is extremely cost-effective 1

Re-evaluation at 2 Weeks

• Assess range of motion, splint fit, and any adverse effects such as skin erosion or increased pain 4
• If symptoms are worsening or not improving, consider advanced imaging (MRI or ultrasound) to rule out more serious pathology such as ligament rupture or occult fracture 4
• Consider specialist referral if minimal improvement is noted 4

Expected Recovery Timeline

Recent evidence shows that 63% of patients with PIP joint sprains achieve complete resolution of swelling within 1 year, though many continue to experience some stiffness and dysfunction 5. Of those who achieve swelling resolution, 47% still report limitations in range of motion and 41% have limitations in activities of daily living 5. This underscores the importance of early active motion to minimize long-term stiffness.

Common Pitfalls to Avoid

• Over-immobilization beyond 4 weeks leads to unnecessary stiffness that can be very difficult to treat and may require multiple therapy visits or even surgical intervention 1
• Continuing splint use beyond the necessary time delays recovery and increases the risk of permanent stiffness 4
• Inadequate patient education about the expected prolonged recovery (swelling may persist for months) can lead to poor compliance and anxiety 5
• Failing to initiate active motion exercises for unaffected fingers immediately increases the risk of hand stiffness, which is one of the most functionally disabling complications 1