Base fractures of the fifth proximal phalanx can be treated conservatively with buddy taping and immediate mobilisation

Introduction

Treatment of base fractures in the proximal phalanx depends on the fracture type, the degree of displacement and whether fracture reduction is stable or not. Internal fixation often leads to decreased mobility of the injured finger despite exact reduction of the fracture. Our treatment is focused upon function and to a lesser extent on exact reposition of the fractured fifth digit. Buddy taping was used after initial, closed reduction of the fracture allowing for immediate mobilisation.

Material and methods

This was a prospective follow-up study of 53 consecutive conservatively managed base fractures in 53 patients with a mean age of 39 years. All fractures were treated with buddy taping to the fourth digit and immediate mobilisation.

Results

The subjective outcome showed high overall satisfaction, and only four patients reported mild pain at rest or work. Malrotation was noted in three cases, none of which needed corrective surgery. All but one patient regained full flexion of the affected finger. Satisfactory extension was seen as only two patients had a lack of extension in both the metacarpo-phalangeal and the proximal interphalangeal joint. No nonunion or delayed unions occurred.

Conclusion

In the literature there is no consensus on the treatment of fractures in the base of the proximal phalanx in the fifth digit. We propose conservative management with buddy taping which enables immediate mobilisation of this particular fracture.

Funding

Not relevant.

Trial registration

No trial registration of this quality study was performed.

Correspondence: Lars Vadstrup. E-mail: lars.soelberg.vadstrup.01@regionh.dk

Conflicts of interest: Disclosure forms provided by the authors are available with the full text of this article at www.danmedj.dk

Reference: Dan Med J 2014;61(8):A4882