What is included in the initial treatment of middle phalanx fractures?

Updated: Jan 18, 2018
  • Author: Jay E Bowen, DO; Chief Editor: Craig C Young, MD  more...
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Nondisplaced middle phalangeal fractures without impaction require only dynamic splinting or “buddy taping” for 2-3 weeks. This allows early motion and decreases joint stiffness.

Angulation and rotation are 2 features of instability that must be examined. Volar angulation is more common than dorsal angulation. Midshaft fractures can result in a dorsal or volar deformity. When angulation is present, closed reduction is necessary for bone realignment. Digital blocking can provide adequate anesthesia. For dorsal angulation, closed reduction is accomplished by longitudinal traction without distal fragment flexion. For volar angulation, closed reduction by longitudinal traction is followed by flexion of the distal fragment to line up with the proximal fragment.

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