Treatment of Middle Phalanx Fractures

Assessment and Classification

• Careful assessment for obvious deformity, swelling, bruising, severe pain with movement, or inability to move the affected digit is essential 1

Non-operative Management

• Rigid immobilization is preferred over removable splints for displaced fractures requiring non-surgical treatment 2
• For immobilization of acute fractures, a sling is generally preferred over figure-of-eight bracing 3
• Appropriate pain management, activity modification, and in some cases bracing may be sufficient for stable fractures 4

Surgical Indications

• Open fractures require surgical intervention 1

Surgical Options

• Percutaneous pinning with Kirschner wires is an option for certain fracture patterns 1

Rehabilitation

• Rehabilitation should include muscle strengthening exercises 1
• Long-term continuation of hand exercises is essential for recovery 1
• Patient education regarding pain management strategies and rehabilitation exercises is important 1

Complications and Follow-up

• Patients should be educated about signs of complications requiring medical attention 1
• If a fractured extremity appears blue, purple, or pale, immediate emergency medical care is necessary 1