Duration of Splinting for Healing Distal Phalanx Fracture
For an uncomplicated distal phalanx fracture showing good healing and near-normal alignment at 1 month, discontinue splinting now and begin active range of motion exercises, as the standard immobilization period of 4-6 weeks has been met.
Recommended Immobilization Duration
- Uncomplicated distal phalanx fractures require splinting of the distal interphalangeal (DIP) joint for 4-6 weeks total 1
- The American Academy of Orthopaedic Surgeons (AAOS) recommends radiographic follow-up at approximately 3 weeks and at the time of immobilization removal to confirm adequate healing 2
- Since your patient's 1-month (4-week) radiograph demonstrates healing and maintained alignment, the minimum immobilization period has been achieved 2, 1
Transition to Active Motion
- Active finger motion exercises should be initiated immediately upon splint removal to prevent stiffness, which is one of the most functionally disabling complications of hand fractures 2, 3
- Finger stiffness can be extremely difficult to treat after fracture healing and may require multiple therapy visits or even additional surgical intervention 2
- A home exercise program should be prescribed for rehabilitation to restore full range of motion 2
Key Clinical Considerations
- Confirm that the fracture was minimally displaced initially, as the AAOS recommends removable splints specifically for this fracture pattern 2
- If there was significant displacement, dorsal tilt, or intra-articular involvement at initial presentation, longer immobilization or surgical management may have been indicated 2
- Monitor for any signs of re-displacement during the transition to active motion, though this is uncommon with adequately healed fractures 2
Common Pitfall to Avoid
- Do not continue immobilization beyond 6 weeks unless there are specific concerns about healing, as prolonged immobilization significantly increases the risk of permanent stiffness 2, 3
- The risk of stiffness from over-immobilization outweighs the minimal benefit of extended splinting once radiographic healing is confirmed 2, 1