Splinting Treatment for Tuft Fractures of the Fourth and Fifth Fingers

Initial Management

For tuft fractures of the fourth and fifth fingers, protective splinting in the position found with a padded splint that allows for active finger motion is the recommended treatment approach, according to the American Heart Association, as published in Circulation 1
Stabilize the extremity with a splint in the position found, without attempting to straighten the injured finger, to prevent further damage 1
The splint should be padded to cushion the injury and prevent further damage, and should be comfortably tight but not constrictive, allowing a finger to be slipped under it 1
Cover any open wounds with a clean dressing before splinting to prevent infection 1

Use a rigid finger splint that protects the fracture site while allowing for motion of unaffected joints, as recommended by the American Academy of Orthopaedic Surgeons 2
Ensure the splint is comfortably tight but not constrictive, allowing a finger to be slipped under it, to promote healing and prevent complications 1

Instruct patients to perform active finger motion exercises following diagnosis to prevent stiffness, as recommended by the American Academy of Orthopaedic Surgeons 2
Regular movement of the fingers through a complete range of motion helps minimize complications, such as hand stiffness, which is one of the most functionally disabling adverse effects of finger injuries 2
Finger motion does not adversely affect adequately stabilized fractures and is extremely cost-effective, making it a crucial part of the treatment protocol 2

Apply cold to the injury site to decrease hemorrhage, edema, pain, and disability, using a plastic bag or damp cloth filled with a mixture of ice and water, with a barrier such as a thin towel between the cold container and the skin 1
Limit cold application to periods of 20 minutes, or 10 minutes if uncomfortable, to prevent tissue damage 1

Radiographic follow-up is recommended at approximately 3 weeks, as suggested by Praxis Medical Insights 3
If there is significant displacement (>3mm) or intra-articular involvement, surgical management may be indicated, according to Praxis Medical Insights 3

If the injured extremity appears blue or extremely pale, seek immediate medical attention as this could indicate a vascular emergency, as warned by the American Heart Association, as published in Circulation 1