What is the appropriate medical management for an uncomplicated closed finger fracture in a healthy adult?

Appropriate MME for Fractured Finger

I cannot provide an appropriate MME (morphine milligram equivalent) recommendation for a finger fracture because the evidence does not support routine opioid use for uncomplicated finger fractures, and the question appears to conflate pain management with opioid dosing.

Pain Management for Finger Fractures

Finger fractures should be managed with multimodal analgesia prioritizing non-opioid analgesics, adequate immobilization or fixation, and early mobilization exercises rather than opioid-based pain control. 1

Initial Pain Control Strategy

• Use non-opioid analgesics as first-line treatment for pain management in uncomplicated finger fractures 1
• Adequate immobilization itself provides significant pain relief by stabilizing the fracture 2
• The support of compression devices (such as compression gloves for metacarpal fractures) helps relieve pain without requiring splintage 3

Treatment-Specific Pain Management

For distal phalanx fractures:

• Splint the distal interphalangeal joint for 4-6 weeks, which provides pain control through stabilization 4
• Patients typically experience negligible pain at follow-up with appropriate splinting 5

For mallet finger (dorsal avulsion fractures):

• Strict splint immobilization for 8 weeks provides adequate pain control 4
• Continuous extension splinting results in negligible pain at 2-year follow-up 5

For middle and proximal phalanx fractures:

• Buddy splinting for minimally angulated fractures (<10 degrees) provides adequate pain relief 4
• Stable fixation through surgical intervention when indicated reduces pain by preventing motion at the fracture site 6

Early Mobilization Reduces Pain

Begin early finger motion exercises immediately after adequate stabilization to prevent edema and stiffness, which are major sources of ongoing pain. 1, 2

• Active finger motion exercises should start following diagnosis of the fracture 1
• Early mobilization is critical for both operative and nonoperative treatment 2
• When immobilization is discontinued, aggressive finger and hand motion exercises are necessary 1, 2

Common Pitfalls

• Avoid over-reliance on opioids when adequate immobilization and non-opioid analgesics can provide sufficient pain control 1
• Do not delay mobilization exercises due to fear of pain, as early activity actually improves outcomes and reduces long-term pain 2
• Recognize that finger stiffness from inadequate early motion becomes very difficult to treat and causes more functional disability than the original fracture 1

Clinical Context

The evidence consistently shows that most symptomatic finger fractures are adequately treated with analgesics (non-opioid), activity modification, and appropriate immobilization 1. Patients with properly managed finger fractures express negligible pain and minimal difficulties with activities of daily living at follow-up 5. This suggests that if significant opioid requirements are being considered, the fracture may be inadequately stabilized or there may be complications requiring reassessment rather than escalating opioid doses.