Executive Editor: Chris Colton

Authors: Fiesky Nuñez, Renato Fricker, Matej Kastelec, Terry Axelrod

Middle phalanx - DIP joint - oblique unicondylar fractures

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Protect the digit with buddy strapping to the adjacent finger, to neutralize lateral forces on the finger.
While the patient is in bed, use pillows to keep the hand elevated above the level of the heart to reduce swelling.

After K-wire fixation
After K-wire fixation, the DIP joint has to be immobilized in extension, leaving the PIP joint free . Either an alumaform splint, or a custom-made thermoplastic splint can be used.
Remove K-wires after 3 weeks, keeping the splint for an additional 2 weeks.

Follow up
See the patient 5 days and 10 days after surgery.

Functional exercises
The patient can begin active motion (flexion and extension) immediately after surgery.
For ambulant patients, put the arm in a sling and elevate to heart level.

Instruct the patient to lift the hand regularly overhead, in order to mobilize the shoulder and elbow joints.

Implant removal
The implants may need to be removed in cases of soft-tissue irritation.
In case of joint stiffness, or tendon adhesion’s restricting finger movement, tenolysis, or arthrolysis become necessary. In these circumstances, take the opportunity to remove the implants.

v1.0 2008-11-08