The _treatment_ consists in reducing the fracture by extension in the attitude of full abduction and applying an accurately fitting pad over the extremity of the displaced bone, maintained in position by a light angular splint. This splint is first fixed to the extended and abducted thumb, and while extension is made by pushing it downwards the upper end is fixed to the wrist (Fig. 54 A). The apparatus is worn for three weeks, being carefully readjusted from time to time to maintain the extension and abduction. A moulded poroplastic splint added on the same principle may be employed, and is more comfortable (Fig. 54 B). Excellent results are obtained after reduction of the displacement, by massage and movement from the first, and the support merely of a figure-of-eight bandage (Pirie Watson).
[Illustration: FIG. 54.--A. Splint applied as used by Bennett. B. Poroplastic Moulded Splint for Bennett's Fracture.]
#Fractures of phalanges# usually result from direct violence, and on account of the superficial position of the bones, are often compound, and attended with much bruising of soft parts. Force applied to the distal end of the finger may also fracture a phalanx. The proximal phalanges are broken oftener than the others. The deformity is usually angular, with the apex towards the palm, and if union takes place in this position, the power of grasping is interfered with. Unnatural mobility and crepitus can usually be recognised, but, on account of the swelling and tenderness, the fracture is apt to be overlooked. Firm union takes place in two or three weeks. In oblique and comminuted fractures, union may take place with overlapping, producing a deformity which may prevent the wearing of a glove or of rings. In compound fractures, non-union sometimes occurs, and causes persistent disability. In doubtful cases radioscopy renders valuable aid, as the parts are readily seen with the screen.
_Treatment._--Early movement and massage are all-important. The contiguous fingers may be utilised as side splints, and a long palmar splint projecting beyond the fingers is applied. In oblique and comminuted fractures it may be necessary to anæsthetise the patient to effect reduction. When it is particularly desirable to avoid deformity, an open operation may be advisable.