Proximal phalanx (finger) fracture: Difference between revisions
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==Workup== | ==Workup== | ||
* Examine the phalanx with the fingers in full extension and flexion | *Examine the phalanx with the fingers in full extension and flexion | ||
* Assess for malrotation | *Assess for malrotation | ||
==Imaging== | ==Imaging== | ||
* AP, lateral, oblique | *AP, lateral, oblique | ||
** Examine for rotation, shortening, angulation | **Examine for rotation, shortening, angulation | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Treatment== | ==Treatment== | ||
* If requires ortho referral: Radial or [[ulnar gutter splint]] | *If requires ortho referral: Radial or [[ulnar gutter splint]] | ||
* Nondisplaced, stable: Consider [[buddy taping]] the injured finger to an adjacent finger | *Nondisplaced, stable: Consider [[buddy taping]] the injured finger to an adjacent finger | ||
** If the ring finger is involved it should be [[buddy taped]] to the little finger | **If the ring finger is involved it should be [[buddy taped]] to the little finger | ||
** Dorsal or volar [[Finger Splint]] if desire added protection | **Dorsal or volar [[Finger Splint]] if desire added protection | ||
* Displaced or angulated fx | *Displaced or angulated fx | ||
** Consider closed reduction | **Consider closed reduction | ||
*** After reduction ensure that PIP joint is in extension, MCP is in flexion (to avoid contracture) | ***After reduction ensure that PIP joint is in extension, MCP is in flexion (to avoid contracture) | ||
==Disposition== | ==Disposition== | ||
* Refer for: | *Refer for: | ||
** Intraarticular | **Intraarticular | ||
** Unstable | **Unstable | ||
*** Spiral or oblique fx | ***Spiral or oblique fx | ||
*** Condylar fx | ***Condylar fx | ||
*** Neck fx | ***Neck fx | ||
*** Large avulsion fx | ***Large avulsion fx | ||
** Rotated | **Rotated | ||
*** NO degree of rotation is acceptable following a reduction | ***NO degree of rotation is acceptable following a reduction | ||
** Shortened | **Shortened | ||
** Significantly angulated | **Significantly angulated | ||
*** Less than 10 degrees may be tolerated | ***Less than 10 degrees may be tolerated | ||
==See Also== | ==See Also== | ||
Revision as of 02:45, 8 July 2016
Background
Workup
- Examine the phalanx with the fingers in full extension and flexion
- Assess for malrotation
Imaging
- AP, lateral, oblique
- Examine for rotation, shortening, angulation
Differential Diagnosis
Hand and Finger Fracture Types
Treatment
- If requires ortho referral: Radial or ulnar gutter splint
- Nondisplaced, stable: Consider buddy taping the injured finger to an adjacent finger
- If the ring finger is involved it should be buddy taped to the little finger
- Dorsal or volar Finger Splint if desire added protection
- Displaced or angulated fx
- Consider closed reduction
- After reduction ensure that PIP joint is in extension, MCP is in flexion (to avoid contracture)
- Consider closed reduction
Disposition
- Refer for:
- Intraarticular
- Unstable
- Spiral or oblique fx
- Condylar fx
- Neck fx
- Large avulsion fx
- Rotated
- NO degree of rotation is acceptable following a reduction
- Shortened
- Significantly angulated
- Less than 10 degrees may be tolerated
See Also
References
UpToDate