Name of the Procedure:

Closed Treatment of Distal Phalangeal Fracture, Finger or Thumb; with Manipulation

Summary

This procedure involves the non-surgical treatment of a broken bone in the tip of the finger or thumb. It includes manually realigning the bone fragments without making any incisions.

Purpose

The procedure is designed to treat fractures in the distal phalanx (the small bone at the fingertip) of the finger or thumb. The goal is to properly align the bone fragments to ensure correct healing and function, reduce pain, and minimize deformity.

Indications

• Pain, swelling, and tenderness at the fingertip.
• Visible deformity or misalignment of the fingertip.
• Difficulty or inability to use the finger or thumb normally.
• X-ray evidence of a distal phalangeal fracture.

Preparation

• No special preparation is typically needed.
• An X-ray or other imaging tests will be performed to assess the fracture.
• The healthcare provider may review the patient's medical history and any current medications.

Procedure Description

1. The patient is seated or lying down, and the affected finger or thumb is cleaned.
2. Local anesthesia may be injected to numb the area and minimize discomfort.
3. The healthcare provider manually manipulates the bone fragments, aligning them correctly.
4. Once aligned, a splint or cast is applied to immobilize the finger or thumb and maintain proper alignment during healing.
5. The finger/thumb is re-imaged to confirm the successful realignment.

Duration

The procedure typically takes about 30 to 45 minutes.

Setting

The procedure is usually performed in an outpatient clinic, emergency room, or doctor's office.

Personnel

• An orthopedic surgeon or an emergency medicine physician.
• Nursing staff to assist with patient care and splint application.
• Radiology technician for imaging.

Risks and Complications

• Pain or discomfort during manipulation.
• Incomplete or improper alignment of the bone.
• Delayed healing or nonunion of the bone.
• Infection, especially if there’s a break in the skin.
• Stiffness or decreased range of motion in the finger or thumb.

Benefits

• Properly aligned fracture promotes natural healing.
• Reduces pain and prevents complications associated with untreated fractures.
• Improved finger/thumb function and appearance.

Recovery

• Patients may need to wear a splint or cast for several weeks.
• Follow-up appointments for X-rays to ensure proper healing.
• Patients may need physical therapy to restore motion and strength.
• Pain management may include over-the-counter pain relievers.
• Avoid heavy lifting or activities that may stress the finger/thumb.

Alternatives

• Open reduction and internal fixation (surgery) for more complex fractures.
• Buddy taping or using a splint without manipulation, though this may not provide optimal alignment.
• Conservative management with rest and over-the-counter pain relief, which may not be suitable for all fractures.

Patient Experience

Patients may experience discomfort during the manipulation, but local anesthesia can help minimize this. After the procedure, there may be soreness, which is manageable with pain medication. The finger or thumb will be immobilized, so patients should expect some limitations in hand use. Regular follow-ups will be necessary to monitor healing.