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General Orthopaedics

Conservative management of proximal phalanx fractures: a prospective study

The South African Orthopaedic Association (SAOA) 58th Annual Congress



Abstract

Aim

We aimed to assess the efficacy of conservative management of proximal phalanx fractures in a plaster slab.

Methods

23 consecutive patients with proximal phalanx fractures were included in this prospective study. The fractures were reduced and the position was held with a dorsal slab for three weeks. They were followed up an average of 7 weeks (range 2 to 45) after the injury. Radiographic confirmation of adequate reduction was carried out each week until union. After removal of the plaster, range of motion of the finger and radiological evidence of union, non-union or malunion was documented.

Results

In united fractures, an average angulation of 4° (apex volar) was measured (range 0 to 45°). In one case (45°) this was not acceptable. All other cases measured less than 15° of angulation. On the AP radiograph the angulation was on average 2° (range 0 to 8°). On average 1.3 mm of shortening (range 0 to 5mm) were measured. In one case delayed union with rotational deformity of 20° was evident. After removal of the slab mild stiffness was noted in one case at the metacarpophalangeal joint and in two cases at the proximal interphalangeal joint.

Conclusion

Most proximal phalanx fractures can be managed conservatively with acceptable results.

NO DISCLOSURES