Objective: To determine whether a relationship exists between the timing of commencement of active range of motion (AROM) exercises and the total active range of motion (TAM) at six weeks post- operatively following surgical fixation of finger proximal phalangeal fractures

Methods: A retrospective audit of all medical documentation for patients who underwent either open or closed surgical fixation of a finger proximal phalanx fracture and commenced their post- operative Hand Therapy at Sydney Hospital Hand Unit between January 2007 and October 2008. Proximal phalangeal fractures that were part of a multi-trauma to the hand were excluded.

Results: A total of 85 surgically fixated proximal phalangeal fractures in 83 patients (average patient age 35 years) were included for review. The average delay between surgery and commencement of AROM exercises was 10.5 days. The TAM at 6 weeks post- operatively for the injured finger was greater for those who commenced AROM exercises within 7 days post- operatively compared with those who commenced AROM exercises after this time. The fractures that underwent open reduction internal fixation with plate and/or screws commenced AROM exercises on average 10 days earlier and at 6 weeks post- operatively demonstrated an average TAM 56 degrees greater than those stabilised using closed reduction and k-wire fixation.

Conclusion: Delay to commencement of AROM exercises within Hand Therapy beyond 7 days post- operatively following surgical fixation of proximal phalangeal fractures in the finger correlated with a reduced TAM at 6 weeks post operatively.