Functional treatment of physeal and periphyseal injuries of the metacarpaland proximal phalangeal bones

Background/Purpose: Hand fractures are common injuries in infants. Complica tions are rare because of potent remodeling dimension and rapid healing of growing bone. There is limited remodeling capacity for angular and rotation al deformity so displaced fractures often require open reduction and intern al fixation. Methods: The authors present a splint system for a protected reduction and mobilization program of displaced proximal phalanx and metacarpal fractures . The custom-molded 2-component thermoplastic splint allows motion of the p roximal interphalangeal (PIP) and distal interphalangeal (DIP) joints. It h as been developed to allow bone healing and recovery of motion at the same time. In this study, the authors evaluated the clinical and radiologic resu lts of a series of 11 consecutive infants with displaced metacarpal fractur es and 13 displaced proximal phalanx fractures who received functional trea tment. Results: Fracture consolidation and full active motion was achieved simulta neously in 4 weeks in 21 children; 2 infants required physiotherapy, and 1 child was lost to follow-up. No further growth abnormality was seen within a 12-month observation period. Conclusion: When there is no damage of soft tissue the functional mobilizat ion program can lead to good results treating displaced physeal and periphy seal hand injuries of proximal phalanx and metacarpal fractures.