Treatment of Fractured Distal Phalanx

Assessment and Classification

Fractures can be classified as displaced (>3mm displacement) according to the American Academy of Orthopaedic Surgeons 1

Surgical fixation is suggested for fractures with significant displacement (>3mm), dorsal tilt >10°, or intra-articular displacement by the American Academy of Orthopaedic Surgeons and other medical guidelines 1, 2
Removable splinting is appropriate for minimally displaced fractures, with a duration of immobilization typically lasting 3-4 weeks, and radiographic follow-up at approximately 3 weeks to confirm adequate healing 2
Active finger motion exercises should be performed following diagnosis to prevent stiffness 2

Immobilization-related adverse events occur in approximately 14.7% of cases and may include skin irritation and muscle atrophy 2
Joint stiffness is a potential complication without proper treatment 2

Radiographic evaluation should be performed initially to confirm diagnosis and fracture pattern, at approximately 3 weeks post-immobilization to assess healing, and at the time of immobilization removal to confirm adequate healing 2

Finger motion exercises are essential and do not adversely affect adequately stabilized fractures, as recommended by the American Academy of Orthopaedic Surgeons, with a strength of evidence supporting cost-effective intervention and significant impact on patient outcomes by preventing finger stiffness 3
The American Academy of Orthopaedic Surgeons advises against over-immobilization, as excessive immobilization leads to stiffness, which can be difficult to treat after fracture healing and may require multiple therapy visits or additional surgical intervention 3
Patients should be instructed to move uninvolved fingers regularly through complete range of motion to prevent complications, as suggested by the American Academy of Orthopaedic Surgeons 3