Middle or Proximal Phalanx Shaft Fractures


Mechanism of Injury

Clinical Presentation

Imaging

Treatment
  Initial Treatment
Splint type & position

Buddy taping for nondisplaced fractures
Gutter splint after closed reduction

Initial follow-up visit Within 7 to 10 days
Pt instructions

Keep hand elevated
Maintain active ROM of uninjured fingers

  Follow-up Care
Cast or Splint type & position

Nondisplaced: buddy taping
Stable after reduction: gutter

Length of immobilization

3 to 4 weeks for buddy taping
4 weeks for splinting

Healing time 4 to 6 weeks
Follow-up visit interval

Every 1 to 2 weeks to assess joint motion and return to normal hand function

Repeat radiography interval

Within 7 to 10 days to check for alignment
Every 1 to 2 weeks for reduced fractures

Pt instruction

Encourage active motion while buddy taped
Active ROM exercises after splinting
Buddy taping protection during sports for 4 to 6 weeks after clinically healed

Indications for Ortho consult

Malrotation or uncorrected angulation
Oblique or spiral fractures
Intraarticular fractures of one or both condyles
Loss of alignment at any time during immobilization

Return to Work or Sports