Rehabilitation following extra-articular proximal phalangeal fractures of the fingers in adults: a scoping review

Journal article


Nele Vervloesem, Glassey, N. and Alison Kerr 2023. Rehabilitation following extra-articular proximal phalangeal fractures of the fingers in adults: a scoping review. Hand Therapy. 28 (2), p. 45–59. https://doi.org/10.1177/17589983231155270
AuthorsNele Vervloesem, Glassey, N. and Alison Kerr
Abstract

Introduction

Proximal phalangeal fractures are common and can have a significant impact on hand function. Therefore, it is important to optimise post-operative rehabilitation. A scoping review was undertaken to map the existing evidence on rehabilitation of proximal phalangeal fractures of the fingers in adults.

Methods

A comprehensive search was conducted which included database searching, reference searching, hand searching of journals, and searching for grey literature. Eight articles were included after screening for eligibility.

Results

Three studies researched surgical interventions and five studies conservative management. The immobilisation period varied between 5 days to 3 weeks in the surgical studies, and between 3 to 7 weeks in the conservative studies. Active exercise therapy was started immediately with conservative management, while in the surgical studies time to commence exercises varied between 5 days and 3 weeks. All studies reported good results in mobility with a mean total active motion ranging from 240° to 258.9°. Patients reported little pain at final follow-up and grip strength recovered to 96% compared to the unaffected side. Studies reporting on function and patient satisfaction lacked transparency.

Conclusions

All studies had a moderate to high risk of bias and the results of the included studies should therefore be interpreted with caution. More high-quality randomised controlled studies with an a priori research protocol and a standard set of outcome measures are necessary to research whether early motion, an intrinsic plus splint leaving the wrist free, and the inclusion of additional treatment modalities can result in a better and/or faster recovery.

KeywordsRehabilitation; extra-articular proximal phalangeal fractures; fingers
Year2023
JournalHand Therapy
Journal citation28 (2), p. 45–59
PublisherSAGE Publications
ISSN1758-9983
1758-9991
Digital Object Identifier (DOI)https://doi.org/10.1177/17589983231155270
Web address (URL)http://dx.doi.org/10.1177/17589983231155270
Output statusPublished
Publication dates12 Feb 2023
Publication process dates
Accepted19 Jan 2023
Deposited22 May 2023
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https://repository.derby.ac.uk/item/9yx7w/rehabilitation-following-extra-articular-proximal-phalangeal-fractures-of-the-fingers-in-adults-a-scoping-review

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