Traction splinting (EAVAST protocol) versus operative fixation of proximal phalanx fractures: a comparative study of patient outcomes

Introduction: Phalangeal fractures are common, frequently deformed and unstable, regularly managed operatively. However, closed methods of reduction increasing. This study aimed to compare functional outcomes for a non-operative cohort using skin traction method developed by the Nepean Hospital, Sydney, Australia, termed ‘early active vector adjustable traction’ or EAVAST, compared operatively patients as potential alternative management proximal phalanx fractures. Methods: A prospective who underwent operative fixation EAVAST protocol between January 2018 2020. Patients were on case-by-case basis fracture type mechanism injury. Functional assessed at three months post intervention total motion, mean strength QuickDASH scores. Measurements conducted independent clinicians with wearing gloves blind assessor signs intervention. Results: Of 38 identified inclusion in study, 15 23 traction. There no significant differences found two groups all outcome measures. The scores 90.8 per cent versus 90.7 (P = 0.97), 84 79 0.58) 1.48 2.5 0.54), respectively. Conclusions: We clinically statistically difference Future is now warranted, ideally multi-centre randomised controlled trial blinded assessment in-cluding cost–benefit analysis comparing standardised techniques.