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Eur J Pediatr Surg 2013; 23(04): 317-321
DOI: 10.1055/s-0033-1333636
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Functional-Conservative Treatment of Extra-articular Physeal Fractures of the Proximal Phalanges in Children and Adolescents

Torsten Franz
1   Department of Surgery, Uster Hospital, Uster, Switzerland
2   Department of Hand and Plastic Surgery, Luzerner Kantonsspital, Lucerne, Switzerland
,
Abdul R. Jandali
3   Department of Hand and Plastic Surgery, Kantonsspital Winterthur, Winterthur, Switzerland
,
Florian J. Jung
3   Department of Hand and Plastic Surgery, Kantonsspital Winterthur, Winterthur, Switzerland
,
Franck M. Leclère
4   Department of Plastic and Hand Surgery, Inselspital Bern, Bern, Switzerland
,
Urs von Wartburg
2   Department of Hand and Plastic Surgery, Luzerner Kantonsspital, Lucerne, Switzerland
,
Urs Hug
2   Department of Hand and Plastic Surgery, Luzerner Kantonsspital, Lucerne, Switzerland
› Author Affiliations
Further Information

Publication History

19 September 2012

19 November 2012

Publication Date:
26 February 2013 (online)

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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).

Keywords

pediatric fractures - finger - proximal phalanx - functional treatment
 

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