Treatment of Non-Displaced Distal Phalanx Fracture with Articular Extension

Assessment and Initial Management

Standard 3-view radiographic examination should be performed to confirm proper alignment and fracture pattern before initiating treatment, as recommended by the American College of Radiology 2
Fractures are classified as significantly displaced when there is >3mm displacement or >10° dorsal tilt, according to the American College of Radiology guidelines 1
The presence of intraarticular extension requires careful evaluation, but non-displaced intraarticular fractures can typically be managed conservatively, as stated by the American College of Radiology 1

For non-displaced intraarticular fractures of the distal phalanx, a removable splint that immobilizes the distal interphalangeal (DIP) joint while allowing proximal interphalangeal (PIP) joint motion should be applied, as recommended by the American College of Radiology 1
Duration of immobilization should typically last 3-4 weeks, according to the American College of Radiology guidelines 1
Active finger motion exercises for non-immobilized joints should be performed following diagnosis to prevent stiffness, as stated by the American College of Radiology 1

Immobilization-related adverse events occur in approximately 14.7% of cases and may include skin irritation and muscle atrophy, according to the American College of Radiology 1
Intraarticular fractures have a risk of developing post-traumatic arthritis if not properly managed, as stated by the American College of Radiology 3
Joint stiffness is a common complication without proper treatment and rehabilitation, according to the American College of Radiology 1, 3

Radiographic follow-up should be performed at approximately 3 weeks post-immobilization to assess healing, as recommended by the American College of Radiology 1
Additional radiographic evaluation should be done at the time of immobilization removal to confirm adequate healing, according to the American College of Radiology guidelines 1