Proximal phalanx fracture treated by a Lucerne cast with early active motion.

Abstract

This retrospective study presents the results obtained using an early active motion protocol for all types of closed proximal phalanx fractures, with or without initial rotational deformity or extension lag, treated with a Lucerne cast. Out of the 71 patients included in the study, 54 responded (71 fractures; response rate: 76%). Assessment was conducted using the total active motion score, (TAM) grip strength, and key pinch. A series of questionnaires were also administered, including a visual analogic scale (VAS) for pain and satisfaction, the Michigan Hand Outcomes Questionnaire (MHQ), the patient-rated wrist/hand evaluation and the SF-36 score. The minimum follow-up period was six months. The mean TAM score was 90.9% compared to the uninjured side. The VAS satisfaction score was 86.2%, the VAS pain score was 1.0 points and the MHQ score was 83.8 points versus 92.9 points for the uninjured side. Fourteen percent of patients experienced complications. In conclusion, conservative treatment of extra- and intra-articular proximal phalanx fracture using an early active motion protocol in a Lucerne cast is favourable, providing excellent results in terms of mobility, force, function, and patient-related outcomes. LEVEL OF EVIDENCE 4: Retrospective study (case series).