Traction splinting phalanx fractures: A case study

Abstract

Abstract: Sports are the main cause of fracture in the 10–29-year-old age group,1.DeJonge J.J. Kingma J. van der Lei B. Klasen H.J. Phalangeal fractures of the hand: an analysis of gender and age-related incidence and aetiology.J Hand Surg [Br]. 1994; 19: 168-170Crossref PubMed Scopus (53) Google Scholar and finger fractures caused by sports can sideline athletes for many weeks to months. Comminuted phalanx fractures are commonly treated with open reduction, percutaneous pinning, screws, plates, k-wires, or tension-band wiring.2.Snead D. Rettig A.C. Hand and wrist fractures in athletes.Curr Opin Orthopaed. 2001; 12: 160-166Crossref Scopus (2) Google Scholar, 3.Stahl S. Jupiter J.B. Salter-Harris types III and IV epiphyseal fractures in the hand treated with tension-band wiring.J Pediatr Orthopaed. 1999; 19: 233-235Crossref PubMed Scopus (12) Google Scholar All of these treatments are invasive and impose the potential risk of infection. Presented is a case study of an 11-year-old boy who suffered a right-dominant index finger comminuted proximal phalanx fracture with dorsal angulation, rotated ulnarly, when he was tackled during a football game. This patient was treated completely closed in the James position of rest with traction applied to the digit for four weeks. The traction was applied with a volar, radial pull. Radiographs were taken immediately after the traction was applied and then at days 3 and 5 to ensure that alignment was maintained. Traction was maintained for four weeks, and the digit was splinted for two subsequent weeks for protection. The fracture healed and at eight weeks he was able to make a full composite fist. This case study consists of a PowerPoint presentation with radiographs from the date of injury through his status at three months after injury. Proposed is a method for noninvasive management of angulated and rotated phalanx fractures.