Immobilization and Treatment of Distal Phalanx Tuft Fractures

Treatment Approach

• The American Academy of Orthopaedic Surgeons (AAOS) recommends removable splints for minimally displaced fractures 1
• Radiographic follow-up is recommended at approximately 3 weeks and at the time of immobilization removal to confirm adequate healing 1, 2

Active Finger Motion During Immobilization

• Active finger motion exercises should be performed immediately following diagnosis to prevent stiffness, which is one of the most functionally disabling adverse effects 3, 1
• Finger motion does not adversely affect adequately stabilized fractures in terms of reduction or healing 3, 1
• Finger stiffness can be very difficult to treat after fracture healing, potentially requiring multiple therapy visits and possibly additional surgical intervention 3

Special Considerations

• If there is significant displacement, dorsal tilt, or intra-articular involvement, surgical management may be indicated instead of conservative treatment 1, 2
• For displaced fractures, rigid immobilization is preferred over removable splints 1
• Monitor for potential complications such as skin irritation or muscle atrophy, which occur in approximately 14.7% of immobilization cases 1, 2

Post-Immobilization Care

• After the immobilization period, gradual return to activities is recommended to prevent re-injury 2
• A home exercise program should be prescribed for rehabilitation to restore full range of motion 2
• Consider adjuvant treatment with vitamin C for the prevention of disproportionate pain during the healing process 4, 2