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Orthopedic Services
Glendale Adventist Medical Center
1509 Wilson Terrace
Glendale, CA 91206
Ph: (818) 409-8000

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Mother fell while using her walker on her back porch and broke her index and middle finger. They put a funny looking cast on her hand that keeps the fingers bent 90 degrees at the knuckles. The cast forms a little "roof" over the back of her fingers. She can bend them all she wants, she just can't straighten them. I've never seen anything like it -- what is the purpose of this type of cast?

It sounds like your mother may have fractured the proximal phalanges of those two fingers. The term phalanges refers to the finger bones. Of the three bones in each of the fingers, the phalanges closest to the hand is the proximal phalange. The little "roof" formed by the cast material blocks motion into extension (fully straightening) of the fingers. That means the extensor tendons (called the extensor hood) are kept tight against the fractured bone and not allowed to contract. It forms a tiny muscular/tendinous "brace" all its own. The fracture is compressed and stabilized by the extensor tendons in this position during the healing phase. Once the X-ray shows the fracture is healed (usually about four weeks), the cast can be removed. If the cast has included the wrist, the person (in this case, your mother) may need hand therapy to restore full wrist and hand motion. Studies show that by the end of 12 weeks (three months), if there have been no other complications, the patient is back to normal (or close to it)!


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