Our hands are constantly exposed during daily activities, making them susceptible to injury. Finger injuries frequently require a period of immobilization using a splint to hold the fingers in a particular position while the damaged structures heal. These splints are often worn for three to six weeks, depending on the healing time required for the tissues that were injured.
Distal Tuft Fracture
Finger injuries most commonly affect the distal phalanx -- the tip of the finger. Fractures of this part of the finger are called tuft fractures and typically occur when the tip of the finger is crushed. These fractures are often treated with a splint, worn for several weeks until the bone heals. A finger splint is applied to immobilize only the distal interphalangeal -- DIP -- joint, the one closest to the tip of the finger. The middle finger joint is left free to move because splinting the entire finger can cause stiffness and decreased function in joints that were not directly impacted by the original injury. DIP splints are often made of foam-padded aluminum or plastic. Custom molded, low-temperature thermoplastic splints are sometimes made by health care professionals to treat this injury.
Mallet finger is a common injury that occurs when an object, such as a ball, hits the tip of the finger. The force of this impact causes the tendon that straightens the tip of the finger to tear. The injury is named for the position assumed by the finger after this injury -- the tip of the finger is bent and cannot be straightened. Mallet finger is typically treated with a splint that holds the joint in a straight position. The splint is typically worn for at least 8 weeks. This allows the damaged tendon time to heal. The splint must be worn all the time, or the finger must be supported in a straight position whenever it is removed. A padded aluminum, plastic or custom thermoplastic splint can be used to treat mallet finger. Only the first joint of the finger is immobilized. The middle joint is free to bend, improving function and preventing unnecessary stiffness.
Shaft fractures occur along the length of any finger bone. If the bones are still in proper alignment, a splint is often worn for three to four weeks while the fracture heals. Although padded aluminum or custom thermoplastic splints are appropriate to treat this injury, often the adjacent finger acts as a splint for the fractured finger. Buddy-taping -- wrapping the injured finger to the finger next to it with athletic tape or premade buddy straps -- is an easy way to splint simple finger shaft fractures.
The proximal interphalangeal, or PIP, joint -- the middle joint of the fingers -- is most commonly dislocated when significant force is applied to one side of the finger. This injury frequently occurs with ball sports. The joint is "reduced," or brought back into correct alignment, by a health care professional. A splint is then applied to the back of the finger, with the knuckle bent to 20 to 30 degrees. A bendable, padded aluminum splint or custom molded thermoplastic splint work best to treat these injuries. The splint is worn for the first week after injury, then the injured finger is buddy taped to an adjacent finger for three to four more weeks while the damaged tissues heal.
Soft tissue finger injuries often heal after several days of rest in a splint. However, medical attention should be sought if pain continues past three days or movement is limited after the splint is removed. Finger fractures aren't always initially apparent, and delayed medical treatment can affect long-term hand function.
- Practical Plastic Surgery for Nonsurgeons: Hand Splinting and General Aftercare
- Practical Plastic Surgery for Nonsurgeons: Tendon Injuries of the Hand
- American Society for Surgery of the Hand: Mallet Finger (Baseball Finger)
- Current Reviews in Musculoskeletal Medicine: Non-Operative Treatment of Common Finger Injuries
- Practical Plastic Surgery for Nonsurgeons: Finger Fractures and Dislocations
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