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Fractures of the phalanges correspond to approximately 23% of all fractures below the elbow, being extremely common at all ages. The current trend for the treatment of unstable, deviated fractures of the phalanges is to perform a rigid fixation and early motion protocol, with the newer low profile plates and screws. However, in our practice, we face ourselves with situations in which it's not possible to perform surgery, due to patient refusal, lack of clinical conditions or financial / insurance issues.

We intend to present on this poster a simple method, originally described by Lorenz Böhler and adapted to our practice, which consists in a local anesthetic block at the office, followed by closed fracture reduction and placing a short arm cast with an aluminum finger splint attached to it, tying the finger to the splint in MP flexion and PIP and DIP extension with adhesive tape. Therefore, any rotational displacement  can be corrected and the extensor mechanism is used as a buttress to prevent displacement in the sagital plane. The treatment lasts for 3 weeks, when the cast/spint is removed, and an early protected motion protocol is initiated to avoid stiffness.

We have been experiencing surprisingly good results with this method, achieving good hand function and correction of finger deformity,and we consider this as an alternative method when surgery is not possible.