Dynamic treatment of displaced proximal phalangeal fractures

We report a splint system for a protected mobilization program (termed dyna mic treatment) of proximal phalangeal fractures. This program can be used f or nonoperative treatment or after operative treatment. Intra-articular fra ctures of the proximal phalanx at the metacarpophalangeal joint were includ ed. The custom-molded 2-component thermoplastic splint allows motion of the proximal and distal interphalangeal joints. It was developed to allow bone healing and recovery of motion at the same time. We evaluated the clinical and radiologic results of a consecutive series of 48 displaced proximal ph alangeal fractures in 45 patients who received dynamic treatment. Fracture consolidation was achieved in all patients and bone healing and recovery of full active motion was achieved simultaneously in all but 4 patients by 6 weeks. The advantage of this splint system is the variability of its applic ation. The splint can be used both for nonsurgical and surgical management. It can be removed to change dressings and for radiologic evaluations. The period of dynamic treatment can be determined individually in each case. (J Hand Surg 1999;24A:1254-1262. Copyright (C) 1999 by the American Society f or Surgery of the Hand.).