Finger splint generally works well for closed fractures.
K-wire fixation by hand surgeon may be needed for open fractures, particularly those affecting the base of the phalanx which is subject to the deforming pull of both the extensor and flexor tendons and not afforded the intrinsic support of the nail.
Source
Jupiter, J, Axelrod, T, and Belsky, M. "Upper Extremity." Browner: Skeletal Trauma, 4th ed.
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