Case Report - (2025) Volume 12, Issue 1
Received: Feb 24, 2024, Manuscript No. JEBMH-24-128194; Editor assigned: Feb 27, 2024, Pre QC No. JEBMH-24-128194 (PQ); Reviewed: Mar 12, 2024, QC No. JEBMH-24-128194; Revised: Feb 24, 2025, Manuscript No. JEBMH-24-128194 (R); Published: Mar 03, 2025, DOI: 10.18410/jebmh/2025/12/01/131
Citation: Cherian SV. Innovative Splinting Technique for Proximal Phalanx Fracture Management: A Case Study. J Evid Based Med Healthc 2025;12(1):131.
This scientific publication presents a unique and tailored strategy for effectively managing a patient with a medial fracture on the head of the proximal phalanx of the left little finger. The case presented posed challenges, including the fragility of the fragment and the patient's reluctance toward surgery due to imminent international employment. In response, an innovative and customized splinting technique was implemented.
The approach showcased in this publication proved to be highly effective in achieving successful immobilization and precise positioning of the fractured fragment. This method offers a valuable alternative, particularly in cases where surgical intervention may be less favorable or feasible. The publication contributes significantly to the field by presenting a tailored solution to address specific challenges in fracture management, taking into consideration individual patient preferences and unique circumstances.
Medial fracture, Proximal phalanx, Splinting technique, Customized splint, Fracture management, Patient preferences, International employment, Tailored solution
The patient presented with a displaced proximal phalanx fracture, and their reluctance to undergo surgery was compounded by the imminent international employment. The main challenge was to devise a solution for immobilization that not only effectively addressed the delicate nature of the fracture fragment but also struck a balance between providing necessary stability and alleviating the patient's concerns regarding surgery and its potential impact on their international employment. The approach had to be carefully tailored to meet both the medical requirements for effective healing and the patient's unique circumstances and preferencesy.1
Proximal phalanx fractures are a common orthopedic injury, particularly among individuals involved in physical activities or manual labor.2 These fractures can result from various mechanisms, including direct trauma, falls, or accidents that involve a forceful impact on the fingers. The proximal phalanx, being the bone closest to the palm in the finger, plays a crucial role in hand function, enabling flexion, extension, and dexterity. When fractured, it can lead to significant pain, loss of function, and impaired daily activities, emphasizing the need for effective and efficient treatment strategies.3
The management of proximal phalanx fractures has evolved over the years.4 Traditional methods include conservative approaches such as casting, splinting, and, in more severe cases, surgical interventions like Open Reduction and Internal Fixation (ORIF). While these methods can achieve successful fracture healing, they are often associated with several challenges. Immobilization through casting or splinting may lead to joint stiffness, muscle atrophy, and delayed rehabilitation. On the other hand, surgical approaches, although precise, may expose the patient to the risks of surgical complications, prolonged recovery time, and increased healthcare costs.5
Given these challenges, there has been an increasing interest in developing alternative, less invasive techniques that can effectively manage fractures while minimizing the drawbacks of traditional treatments.6 One such development is the introduction of innovative splinting techniques that aim to optimize fracture healing, enhance patient comfort, and accelerate the rehabilitation process.7 These techniques focus on stabilizing the fracture while allowing controlled movement, thereby preventing stiffness and promoting early mobilization. The ultimate goal is to balance immobilization with mobility, allowing the fractured bone to heal while maintaining the functionality of the surrounding structures.8
This case study presents an innovative splinting technique specifically designed for the management of proximal phalanx fractures. The splint, constructed using advanced materials and a tailored design, provides both stability and flexibility. Unlike traditional splints that may immobilize the entire finger or hand, this technique allows for selective immobilization of the fractured segment while permitting movement in the unaffected joints. This controlled motion is crucial in preventing the common complications of stiffness and muscle atrophy, which are often observed in conventional treatment approaches.
The patient in this case study, a 32-year-old male, presented with a displaced fracture of the proximal phalanx following a sports-related injury. Initial assessment and imaging confirmed the fracture, and after evaluating the treatment options, the decision was made to employ the innovative splinting technique. Over the course of treatment, the patient demonstrated excellent progress, with early pain relief, rapid reduction of swelling, and notable improvements in range of motion. Follow-up assessments showed satisfactory fracture alignment, with no evidence of malunion or complications.
This case underscores the potential of advanced splinting techniques in revolutionizing fracture management. By addressing the limitations of traditional approaches, this innovative technique offers a promising alternative that combines effective fracture stabilization with early rehabilitation. The implications for clinical practice are significant, suggesting that this approach may be particularly beneficial for patients who wish to avoid the risks associated with surgery or prolonged immobilization.
Following a thorough examination, it was determined that reduction could assist in aligning the fractured piece with the base of the fracture site. To address this, a customized splint was meticulously designed using low-temperature thermo plastic. The splint commenced its wrapping from the dorsal aspect, positioned between the metacarpal heads of the little and ring fingers, applying increased pressure at this specific site for optimal support. As it progressed towards the volar aspect of the little finger, the splint extended seamlessly up to the thumb. The incorporation of a strategically placed hole facilitated easy thumb insertion, eliminating the need for additional straps and enhancing the overall simplicity and effectiveness of the immobilization technique. This tailored approach aimed to provide both stability and comfort in addressing the specific requirements of the fracture (Figure 1).
Figure 1. Proximal phalanx of little finger.
Subsequent X-rays conducted after the application of the splint confirmed the accurate positioning of the fractured piece. The patient reported no pain or discomfort, and the restoration of joint flexion was observed. Importantly, the radiolucency of the splint allowed for periodic X-ray assessments without the need for removal. This feature facilitated continuous monitoring of the fracture site, ensuring the sustained alignment and monitoring of the healing progress. The ability to conduct X-ray assessments without removing the splint was advantageous, preserving the stability provided by the splinting technique and maintaining the patient's comfort throughout the recovery process (Figure 2).
Figure 2. Healing ring and little finger proximal phalanx fractures.
The innovative splinting technique demonstrated remarkable effectiveness in providing immobilization, effectively addressing the patient's concerns about undergoing surgery, particularly given their international commitments. The customized design not only ensured optimal pressure distribution but also played a crucial role in facilitating patient compliance. The tailored nature of the splint, designed to accommodate the unique characteristics of the fracture and the patient's specific needs, resulted in successful immobilization. This approach not only addressed the medical requirements for fracture management but also took into consideration the individual's concerns, contributing to overall comfort and compliance with the treatment plan.
The presented splinting technique emerges as a viable alternative for cases where immediate surgery is not feasible, especially in instances where patient preferences or specific circumstances restrict surgical options. Given the promising outcomes observed, there is potential for further studies and clinical trials to explore the broader applicability of this approach and assess its long-term outcomes. These research endeavors would provide valuable insights into the efficacy, safety, and extended benefits of the innovative splinting technique across diverse clinical scenarios. Such investigations could contribute significantly to the advancement of non-surgical interventions in fracture management, offering alternative solutions for patients with varying needs and constraints.
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