A Multifaceted Physiotherapeutic Approach for Improving Hand Function in Post-traumatic Fracture Dislocation of Proximal Phalanx of Middle Finger of Left Hand: A Case Report

Abstract

Hand phalangeal fractures are frequent injuries that present in the clinic and emergency room. Injuries to the phalanx may occur at the proximal, middle, or distal segments of the bone. Depending on the location, proximal phalanx fractures can develop a volar apex angulation. Soft-tissue damage, along with disruption of the finger, accompanies the phalangeal fracture. Treatment of the phalangeal fracture is contingent upon the type of displacement of the fracture. Displaced fractures are reduced by manipulation, followed by immobilisation in an aluminum splint. In later phases, Kirschner wire (K-wire) fixation is performed. The hand is an important functional unit. Hence, post-immobilisation rehabilitation of the phalangeal fracture is essential for everyday activities. In this case report, the multifaceted physiotherapeutic approach is employed in the rehabilitation of a 33-year-old man who presented with multiple bite wounds allegedly inflicted by a wild boar, with chief complaints of injuries on the third digit of the left hand leading to pain and restricted movement. Radiographs revealed a comminuted fracture of the third digit with fracture dislocation of the distal end of the proximal phalanx, requiring K-wire fixation and finger splinting. Post-fixation, finger Range Of Motion (ROM) reduced, and pain arose, prompting physiotherapy. The multifaceted approach in rehabilitation involves a range of interventions, including traditional methods like immobilisation and K-wire fixation, as well as adjunctive physiotherapy techniques such as the finger blocking technique and sensory motor training. This report showcases a successful multifaceted rehabilitation approach for a patient with a traumatic finger fracture, demonstrating the importance of integrating physical therapy and addressing both physical and functional impairments for optimal outcomes.

Keywords

• finger blocking exercises
• phalangeal fracture
• rehabilitation
• sensory motor training