title: Functional-conservative treatment of extra-articular physeal fractures of the proximal phalanges in children and adolescents.
abstract: BACKGROUND
  Fractures of the proximal phalanges of the fingers are common injuries in children and adolescents. The majority can be treated by closed reduction and splinting, and complications are rare. The purpose of the prospective study was to document the results of functional-conservative treatment of extra-articular physeal fractures using either a functional forearm cast or the Lucerne Cast (LuCa).
  
  
  METHODS
  Clinical and radiographic results of 13 pediatric patients having 13 extra-articular physeal fractures (e.g., juxta-epiphyseal fractures, Salter-Harris type I or II physeal fractures) of the proximal phalanges were recorded through a minimum follow-up of 6 months. Intra-articular physeal fractures (Salter-Harris type III or IV), fractures involving the proximal interphalangeal joint (PIPJ), pathological fractures, open fractures, and concomitant injuries of the tendons were excluded.
  
  
  RESULTS
  Fracture consolidation was achieved in all cases within 4 weeks. No palmar apex angulations, no rotational deformities, and no PIPJ extension lags could be observed. All patients achieved full total active range of motion within 3 months.
  
  
  CONCLUSIONS
  Well-reduced extra-articular physeal fractures of the proximal phalanges can be effectively treated using functional-conservative casts. Although children may need a functional forearm cast, a LuCa is adequate in compliant adolescents.Level of Evidence The level of evidence for the study is Level II (therapeutic studies).
authors: Department of Surgery, Uster Hospital, Uster, Switzerland. torsten.franz@spitaluster.ch
authors: Torsten
authors: T
authors: Franz
authors: Abdul R
authors: AR
authors: Jandali
authors: Florian J
authors: FJ
authors: Jung
authors: Franck M
authors: FM
authors: Leclère
authors: Urs
authors: U
authors: von Wartburg
authors: Urs
authors: U
authors: Hug
mesh_terms: D000293:Adolescent; D002370:Casts, Surgical; D002648:Child; D005260:Female; D050278:Finger Phalanges / Q000293:injuries*; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D016896:Treatment Outcome