Suresh Rajendran1 , Jaganmohan Janardhanam
BACKGROUND Phalangeal fractures are common fractures of the hand. Various treatment protocols and options, ranging from splinting, percutaneous wires, external fixators, interfragmentary screw fixation to mini fragment plates exist in handling cases of proximal phalangeal fractures. The aim of the study is to find the outcome of fingernail traction with a digital aluminium splint in the management of closed phalangeal fractures of the hand. METHODS A prospective study was conducted among 24 patients between November 2017- October 2019 who were treated with Long Aluminium Splint Traction (LAST), a fingernail traction using a long aluminium splint in the management of closed fractures involving proximal and middle phalanx of the hand. The outcome measures included post reduction radiographic evaluation and total active motion (TAM) in the finger at the final follow-up. RESULTS On radiological assessment, 20 patients had good reduction, 2 had fair reduction and 2 patients had poor reduction. At final assessment with TAM score, 19 patients had good TAM score, 3 had fair and 2 had poor TAM. Complication was noted in two cases in the form of misalignment with poor reduction which required ORIF with K- wire fixation. CONCLUSIONS Long aluminium splint is readily available, cost effective and it is simple to apply traction. With traction splinting and early range of motion exercises, these patients were found to have an acceptable outcome with fewer complications when compared to ORIF with plates and screws.
