Treatment of Middle Finger PIP Joint Avulsion Fracture

Initial Assessment and Imaging

Radiography is essential as the initial imaging for suspected finger fractures, with at least 2 views recommended, though adding an oblique view increases diagnostic yield, according to the American Academy of Orthopaedic Surgeons 1
For PIP joint fractures, radiographs should assess displacement of the fracture fragment and articular involvement, according to the American Academy of Orthopaedic Surgeons 1

Rigid immobilization with a splint for 3-6 weeks is indicated for minimally displaced fractures, according to the American Academy of Orthopaedic Surgeons 1
Active finger motion exercises should be performed following diagnosis to prevent stiffness, which is one of the most functionally disabling adverse effects, as recommended by the American Academy of Orthopaedic Surgeons 2
A home exercise program is an option for patients prescribed therapy after fracture immobilization, according to the American Academy of Orthopaedic Surgeons 2

Surgery should be considered when fracture fragment displacement is greater than 3mm or involvement of more than one-third of the articular surface, according to the American Academy of Orthopaedic Surgeons 1
Conservative treatment has failed to provide pain relief or restore function, as indicated by the American Academy of Orthopaedic Surgeons 1

Hand stiffness is one of the most functionally disabling adverse effects following fracture treatment, according to the American Academy of Orthopaedic Surgeons 2
Instructing the patient to move the fingers regularly through a complete range of motion may help minimize the risk of stiffness complications, as recommended by the American Academy of Orthopaedic Surgeons 2
Finger motion does not have adverse effects on an adequately stabilized fracture in regard to reduction or healing, according to the American Academy of Orthopaedic Surgeons 2

Post-treatment monitoring should focus on pain relief and restoration of function, according to the American Academy of Orthopaedic Surgeons 1