title: Conservative treatment of fractures of the proximal phalanx: an option even for unstable fracture patterns.
abstract: OBJECTIVE
  The purpose of the study was to assess the efficacy of the conservative management of proximal phalangeal fractures in a dorsal plaster slab.
  
  
  METHODS
  Twenty-three consecutive patients with extra-articular proximal phalangeal fractures were included in this prospective study. Fourteen patients (62%) presented with fractures considered unstable. The fractures were reduced and the position was held with a dorsal plaster slab for three weeks. The patients were followed up for an average of seven weeks (range 2 to 45) after the injury. Range of motion of the finger and radiological evidence of union, non-union or malunion was documented after removal of the plaster.
  
  
  RESULTS
  Ninety-one percent of fractures maintained an acceptable reduction. All cases measured less than 15° of angulation. On average 1,1 mm of shortening was measured. In two (9%) cases the reduction was not accepted on follow up assessment and the fractures were managed surgically.
  
  
  CONCLUSIONS
  Most extra-articular proximal phalanx fractures can be managed conservatively with acceptable results.
authors.affiliation: Martin Singer Hand Unit, Orthopaedic Department, Groote Schuur Hospital, University of Cape Town, South Africa.
authors.forename: Michael
authors.initials: M
authors.lastname: Held
authors.forename: Pieter
authors.initials: P
authors.lastname: Jordaan
authors.forename: Maritz
authors.initials: M
authors.lastname: Laubscher
authors.forename: Martin
authors.initials: M
authors.lastname: Singer
authors.forename: Michael
authors.initials: M
authors.lastname: Solomons
mesh_terms: D000293:Adolescent; D000328:Adult; D001458:Bandages; D005260:Female; D005383:Finger Injuries / Q000000981:diagnostic imaging* / Q000503:physiopathology; D050278:Finger Phalanges / Q000000981:diagnostic imaging / Q000293:injuries*; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000295:instrumentation*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D055815:Young Adult