Home About Journal AHEAD OF PRINT Current Issue Back Issues Instructions Submission Search Subscribe Blog    

Users Online: 393 
Print this page  Email this page Small font sizeDefault font sizeIncrease font size 
Year : 2005  |  Volume : 39  |  Issue : 3  |  Page : 158-162

Treatment of closed unstable extra articular proximal phalangeal fractures of hand by closed reduction and dorsal extension block cast

Hand surgery unit, Department of Orthopaedics, Sawai Man Singh Medical College and Hospital, Jaipur, India

Correspondence Address:
Abheek Kar
House no 22; 2nd main, 2nd cross, MM Layout, Kaval Byra, Sandra, Bangalore-560032
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0019-5413.36705

Rights and Permissions

Background: Unstable fractures of proximal phalanges have enormous divergence of opinion regarding the treatment. Treatment options range from fancy over the counter splints to the more exotic forms of internal fixation. Method: A total of 62 cases with 72 fractures with ages from 1065 yrs of both sexes were treated. After closed reduction under local anaesthesia the dorsal extension block cast was applied with the metacarpophalangeal joints in full flexion and interphalangeal joints in full extension. This method works on the principle of the intact dorsal soft tissue hinge (extensor apparatus) over the fractured proximal phalanx. The intrinsic plus position keeps the intrinsics lax and prevents them from acting as a displacing force pulling the proximal fragment of the fracture into volar angulation. On an average the cast was used for 3 weeks. Results: Fifty eight fractures had united by 3 weeks. The results were judged according to modified Buck-Gramcko's point assessment system for finger fractures, which showed 80.64% excellent, 4.83% good, 8.06% satisfactory and 6.45% poor results. The complications were minimal which included only 3 cases with malunion. Conclusion: Conservative management of unstable proximal phalangeal fractures with dorsal extension block cast has produced excellent results. It maintains mobility of the fingers without compromising the stability of the fracture and prevents future stiffness of hands. It avoids the complications of operative methods and is simple to use.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded281    
    Comments [Add]    
    Cited by others 2    

Recommend this journal