Distal phalanx (finger) fracture: Difference between revisions
m (Rossdonaldson1 moved page Distal Phalanx (Finger) Fracture to Distal phalanx (finger) fracture) |
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==Background== | ==Background== | ||
*Hand: finger slammed in door | |||
*Foot: stubbed toe or dropped a heavy object | |||
==Clinical Presentation== | ==Clinical Presentation== | ||
*Pain and/or swelling of the digit | |||
*Sensation usually intact | |||
**Pain on palpation | |||
===Examination=== | ===Examination=== | ||
* Evaluate for tendon damage | *Evaluate for tendon damage | ||
*Always look for the second fracture | |||
===Imaging=== | ===Imaging=== | ||
* Comminuted tuft | *Hand Xrays to rule out additional fractures | ||
* Comminuted tuft fracture[[File:Tufts_fracture.jpg|thumb|Tuft's fracture]] | |||
** Stable | ** Stable | ||
* Longitudinal | * Longitudinal fracture | ||
** Usually non-displaced and stable | ** Usually non-displaced and stable | ||
* Transverse | * Transverse fracture | ||
** Evaluate for angulation/displacement | ** Evaluate for angulation/displacement | ||
* Intraarticular | * Intraarticular fracture | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Treatment== | ==Treatment== | ||
* Nondisplaced: Splint with the DIP joint in extension (splint should extend past the tip of the distal phalanx | *Nonoperative | ||
** Do not attempt to reduce comminuted tuft fx | **Nondisplaced: Splint with the DIP joint in extension (splint should extend past the tip of the distal phalanx | ||
***Most cases | |||
**Eval nail bed | |||
***Is a [[Nailbed laceration]] underneath possible? | |||
**Digital blocks can be helpful for evaluation and management | |||
**Do not attempt to reduce comminuted tuft fx | |||
*Call Hand or Ortho (institution dependent) for complex finger injuries | |||
**[[Nailbed laceration]] with distal phalanx fractures can be complicated and result in open fractures | |||
==Disposition== | ==Disposition== | ||
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** Displacement or angulation | ** Displacement or angulation | ||
** Intraarticular fx | ** Intraarticular fx | ||
**Complex involving [[Nailbed laceration]] | |||
==See Also== | ==See Also== | ||
*[[Finger (Phalanx) Fracture]] | *[[Finger (Phalanx) Fracture]] | ||
*[[Hand Diagnoses (Main)]] | *[[Hand Diagnoses (Main)]] | ||
*[[Nailbed laceration]] | |||
*[[Subungual hematoma]] | |||
== | ==References== | ||
<references/> | |||
[[Category:Ortho]] | [[Category:Ortho]] | ||
Revision as of 02:27, 17 April 2015
Background
- Hand: finger slammed in door
- Foot: stubbed toe or dropped a heavy object
Clinical Presentation
- Pain and/or swelling of the digit
- Sensation usually intact
- Pain on palpation
Examination
- Evaluate for tendon damage
- Always look for the second fracture
Imaging
- Hand Xrays to rule out additional fractures
- Comminuted tuft fracture
- Stable
- Longitudinal fracture
- Usually non-displaced and stable
- Transverse fracture
- Evaluate for angulation/displacement
- Intraarticular fracture
Differential Diagnosis
Distal Finger (Including Nail) Injury
- Distal interphalangeal dislocation (finger)
- Distal phalanx (finger) fracture
- Finger amputation
- Fingertip avulsion
- Finger infection
- Nailbed laceration
- Nail avulsion
- Subungual hematoma
Hand and Finger Fracture Types
Treatment
- Nonoperative
- Nondisplaced: Splint with the DIP joint in extension (splint should extend past the tip of the distal phalanx
- Most cases
- Eval nail bed
- Is a Nailbed laceration underneath possible?
- Digital blocks can be helpful for evaluation and management
- Do not attempt to reduce comminuted tuft fx
- Nondisplaced: Splint with the DIP joint in extension (splint should extend past the tip of the distal phalanx
- Call Hand or Ortho (institution dependent) for complex finger injuries
- Nailbed laceration with distal phalanx fractures can be complicated and result in open fractures
Disposition
- Refer for:
- Tendon dysfunction
- Nerve dysfunction
- Displacement or angulation
- Intraarticular fx
- Complex involving Nailbed laceration