Treatment of Small Avulsion Fracture at the Base of the Thumb Interphalangeal Joint

Initial Assessment and Imaging

Radiography is always indicated as the initial imaging for suspected thumb fractures, with at least 2 views recommended (PA and lateral), though adding an oblique view increases diagnostic yield 1, 2
For thumb fractures specifically, radiographs should assess displacement of the fracture fragment (>3mm indicates need for surgery) 1
For thumb fractures specifically, radiographs should assess articular involvement (>1/3 of articular surface indicates need for surgery) 1

Rigid immobilization with a thumb spica cast or splint for 3-6 weeks is indicated for minimally displaced fractures (<2-3mm) 1, 2
Follow-up radiographs should be obtained at 10-14 days to ensure the fracture position is maintained 3

Surgery should be considered when fracture fragment displacement >3mm [1, @16@]
Surgery should be considered when involvement of more than one-third of the articular surface 1
Conservative treatment has failed to provide pain relief or restore function 4

Post-treatment monitoring should be adapted to the patient's individual needs, with particular attention to pain relief 5
Post-treatment monitoring should be adapted to the patient's individual needs, with particular attention to restoration of function 5