Background: The standard treatment for the conservative management of a proximal phalanx fracture of the little finger involves immobilizing the fracture site with a cast. However, cast immobilization presents challenges in maintaining hygiene during treatment and restricts the fine motor movements of the fingers. In this study, we developed a removable orthosis that immobilizes only the ring and little fingers. We examined the splint's effectiveness in joint immobilization and its impact on fine motor movements of the fingers.
Method: Twenty healthy adults were included in this study conducted at the Yokohama Minami Kyosai Hospital, Yokohama, Japan. While wearing a cast and an orthosis, the range of motion of the metacarpophalangeal (MP) joints of the index and little fingers was measured using X-ray fluoroscopy. The Purdue Pegboard Test evaluated fine motor skills, handwriting tasks, and chopstick use tests. We statistically compared the range of motion and fine motor skills of the MP joints in the cast and orthosis.
Results: The range of motion of the MP joint in the index finger was significantly greater with the orthosis than with the cast (p < 0.001). In contrast, in the little finger, the cast allowed a greater range of motion than the orthosis (p < 0.077). Additionally, regarding fine motor skills, in the chopstick task, the orthosis showed significantly better performance than the cast.
Conclusion: The developed orthosis, which immobilized only the ring and little fingers, provided sufficient stability to the little finger while maintaining the index finger's mobility. Additionally, it imposed minimal restrictions on fine motor movements and the use of chopsticks.
Keywords: cast immobilization; conservative treatment; fine motor movements; orthosis; proximal phalanx fractures.
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