Finger nail traction and digital splint in the management of proximal phalangeal fractures

Abstract

Introduction: Proximal phalangeal fractures are common fractures of the hand. There is vicinity of two important joints and crossing of long tendons which make these fractures difficult to treat. The goal of this study was to evaluate the efficacy of nail traction technique in the management of proximal phalangeal fractures of the hand. Material and Methods: This is a prospective study of patients with proximal phalangeal fractures treated by nail traction. Assessment of all patients was done at the time of presentation and there was a standard protocol which was followed for recruiting patients. Assessment of the patients initially was done on 12th day after the application of nail traction. The outcome measures included radiographic evaluation post reduction and total active motion (TAM) in the finger at the final follow up. Follow up of all patients was done for a period of one year. Results: On x-ray evaluation post reduction, good reduction was seen in 33 cases, 8 cases had fair reduction and poor reduction in 2 cases. At final assessment, 35 patients had good, six had fair and two had poor TAM score. Complications were noted in two patients, which included pressure necrosis in palm and stiffness in proximal interphalangeal joint. Conclusions: The results of this study showed that nail traction seems to be simple, safe and effective technique for managing proximal phalangeal fractures.