Comparison Between Buddy Taping With a Short-Arm Splint and Operative Treatment for Phalangeal Neck Fractures in Children

Park, Kun-Bo; Lee, Kwang Jin; Kwak, Yoon Hae

doi:10.1097/bpo.0000000000000521

Cited by 16 publications

(12 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…More recently, most centers (including ours) have adopted a more conservative approach to minimally displaced fractures as long as there is no rotational deformity. 8,10 Our results support the conservative approach in minimally displaced type II D fractures.…”

Section: Discussionsupporting

confidence: 72%

Type II D Phalangeal Neck Fractures in Children: A Series of 20 Cases Treated According to a Preset Stepwise Algorithm

Al‐Qattan

Almohrij

Alaskar

et al. 2021

Journal of Hand and Microsurgery

View full text Add to dashboard Cite

Introduction Type II phalangeal neck fractures are defined as displaced fractures with bone-to-bone contact at the fracture site. In the type II D subtype, the distal fracture fragment is thin. A review of the literature did not reveal any study investigating the outcome of management of these fractures. Patients and Methods This is a retrospective study of 20 consecutive children with type II D phalangeal neck fractures treated over the past 4 years. Demographic data were reviewed. All cases were managed according to the preset stepwise algorithm. The outcome of management at final follow-up was documented using Al-Qattan’s grading system. Results The mean age was 30 months (range 12–80 months). There were 12 males and 8 females. The mean follow-up was 2 years (range 7 months to 3 years). The largest two categories within the management algorithm were patients with minimally displaced fractures treated conservatively (n = 8) and those with displaced fractures treated with closed reduction and percutaneous K-wire fixation (n = 9). Fischer exact test was used to compare the outcome in these two groups and the p value was significant (p = 0.015), indicating a significantly better outcome in the former group. Conclusion Several conclusions were made from the study. Type II D of phalangeal neck fractures tend to occur in young children and the majority involve the middle phalanx. The thinness of the distal fracture fragment makes standard techniques of closed reduction more difficult. However, flexion of the proximal and distal joints appears to be effective in reducing dorsally displaced type II D fractures by closed means. Finally, a more conservative approach to minimally displaced type II D fractures results in a better outcome compared with closed reduction and percutaneous K-wire fixation.

show abstract

Section: Discussionsupporting

confidence: 72%

Type II D Phalangeal Neck Fractures in Children: A Series of 20 Cases Treated According to a Preset Stepwise Algorithm

Al‐Qattan

Almohrij

Alaskar

et al. 2021

Journal of Hand and Microsurgery

View full text Add to dashboard Cite

show abstract

“…Buddy taping for the treatment of finger fractures as an adjunct to protective splinting has been recommended in several studies (Figl et al, 2011;Fok et al, 2013;Franz et al, 2012Franz et al, , 2013Park et al, 2016;Pezzei et al, 1993;Rajesh et al, 2007). The combination of some of these splints with buddy taping allows early mobilization, and it has been demonstrated that this functional treatment prevents stiffening and therefore achieves free mobility and bony healing at the same time.…”

Section: Introductionmentioning

confidence: 99%

“…It is very likely that they have treated not only sprains but also stable fractures by buddy splinting (Aitken and Court-Brown, 2008;Briner and Kacmar, 1997;Chen and Kalainov, 2017;Gaston and Chadderdon, 2012;Shaftel and Capo, 2014 Although buddy taping has been used since the seventies, it is only recently that buddy taping without supplementary splinting was introduced as a recognized treatment modality for fractures in the medical literature. Only a few studies, none of them prospective, have been published on the subject (Figl et al, 2011;Franz et al, 2012Franz et al, , 2013Loosli and Garrick, 1987;Park et al, 2016;Pezzei et al, 1993;Vadstrup et al, 2014). In 2009, buddy taping was recommended as a standard treatment for undisplaced, closed fractures of the proximal phalanx in the American Society for Surgery of the Hand Manual of Hand Surgery (Baltera et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Buddy taping versus splint immobilization for paediatric finger fractures: a randomized controlled trial

Weber

Subotic

Kalisch

et al. 2019

J Hand Surg Eur Vol

View full text Add to dashboard Cite

The purpose of this single-centre randomized controlled trial was to assess the non-inferiority of buddy taping versus splint immobilization of extra-articular paediatric finger fractures. Secondary fracture displacement was the primary outcome; patient comfort, cost and range of finger motion were secondary outcomes. Ninety-nine children were randomly assigned to taping or splinting. Sixty-nine fractures were undisplaced; 31 were displaced and required reduction before taping or splinting. Secondary displacement occurred in one patient in the taping and three in the splinting group. The risk difference was below the predefined non-inferiority level of 5%. All secondary displacements occurred in the 31 displaced fractures after reduction and were in little fingers. Patient comfort was significantly higher and cost lower in the taping group. We conclude from this study the non-inferiority of buddy taping versus splint immobilization of extra-articular paediatric finger fractures in general. We advise treatment may need to be individualized for patients with displaced fractures because we cannot make any absolute conclusions for these fractures. Level of evidence: I

show abstract

“…However, outcomes of nonsurgical treatment for displaced phalangeal neck fractures are not well documented in literature. 9,10 This study was designed to investigate the radiological outcome of phalangeal neck fractures treated nonsurgically. In particular, we wanted to define whether, and by how much, these fractures displace over time.…”

mentioning

confidence: 99%

Outcomes of Phalangeal Neck Fractures in a Pediatric Population

Tan

Lim

Chong

2020

The Journal of Hand Surgery

View full text Add to dashboard Cite

Purpose Displaced pediatric phalangeal neck fractures are regarded as unstable, and hence, surgical fixation is traditionally recommended. In our experience, some patients with displaced fractures treated nonsurgically healed with a good clinical outcome and no further displacement. We studied the outcome of displaced phalangeal neck fractures treated nonsurgically with attention to the change in fracture displacement over time and hypothesized that displaced phalangeal neck fractures can be treated nonsurgically with maintenance of acceptable radiological parameters.Methods A retrospective review of 35 patients aged 16 and younger was conducted. Included patients had at least 10 of angulation or 25% translation in either the coronal or the sagittal plane, with no malrotation. Angulation and translation of the distal fracture fragment in the coronal and sagittal planes was measured from radiographs taken at 2 intervals-within 7 days of the injury and at least 21 days after the injury. Initial and final measurements were compared to determine the amount of fracture displacement that occurred.Results Thirty-five patients with type II A, B, and C fractures (classification according to Al-Qattan) comprised our study sample. Twelve patients had undergone manipulation and reduction. Average radiological follow-up was 4.3 months (range, 0.7e86 months; median, 1.2 months; SD, 14.7). These fractures treated nonsurgically did not displace as the fracture healed, suggesting that type II fractures, although traditionally regarded as unstable, may maintain their radiological parameters without surgical fixation.Conclusions Our findings suggest that displaced phalangeal neck fractures do not necessarily displace with nonsurgical treatment.

show abstract

Comparison Between Buddy Taping With a Short-Arm Splint and Operative Treatment for Phalangeal Neck Fractures in Children

Abstract: Buddy taping with a short-arm splint for treating phalangeal neck fractures had acceptable outcomes compared to that with surgical correction.

Cited by 16 publications

References 21 publications

Type II D Phalangeal Neck Fractures in Children: A Series of 20 Cases Treated According to a Preset Stepwise Algorithm

Type II D Phalangeal Neck Fractures in Children: A Series of 20 Cases Treated According to a Preset Stepwise Algorithm

Buddy taping versus splint immobilization for paediatric finger fractures: a randomized controlled trial

Outcomes of Phalangeal Neck Fractures in a Pediatric Population

Contact Info

Product

Resources

About