Nonoperative treatment

Undisplaced partial articular fractures of the proximal end segment of the proximal phalanx can be treated nonoperatively with controlled movement by buddy strapping to a neighboring finger.

The strapping should leave the joints free for mobilization.

Direct skin contact with adjacent fingers should be prevented by placing gauze pads between them.

The aftercare can be divided into four phases of healing:

• Inflammatory phase (week 1–3)
• Early repair phase (week 4–6)
• Late repair and early tissue remodeling phase (week 7–12)
• Remodeling and reintegration phase (week 13 onwards)

Full details on each phase can be found here.

Follow-up x-rays should be taken after 1 week and possibly every 2 weeks until fracture consolidation.

Buddy strapping is continued until about 4 weeks after the injury. At that time, an x-ray is taken to confirm healing, and range of motion should be pain-free.

Buddy strapping can then usually be discontinued, and active mobilization is initiated. Functional exercises are recommended.

If, after 8 weeks, x-rays confirm healing, full manual loading can be permitted.