Difference between revisions of "Finger (phalanx) fracture"

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==[[Middle Phalanx (Finger) Fracture]]==
 
==[[Middle Phalanx (Finger) Fracture]]==
* Commonly associated with tendon injuries!
 
 
===Examination===
 
* Assess PIP, DIP flexion/extension
 
* Assess PIP, DIP collateral ligaments (varus/valgus stress)
 
 
===Images===
 
* AP, lateral, oblique
 
* Oblique and spiral fractures: evaluate for shortening/malrotation
 
 
===Treatment===
 
* Nondisplaced without angulation:
 
** Buddy tape to adjacent finger
 
*** Buddy tape ring finger to little finger
 
** Dorsal or volar finger splint if desire added protection
 
* Displaced or angulated fx
 
** Closed reduction
 
*** Adequate reduction:
 
**** <1-2mm displacement or shortening
 
**** Up to 10 degrees of angulation
 
**** No amount rotation
 
*** Followed by ulnar or radial gutter splint
 
**** Wrist in 20-30 degrees of extension
 
**** MCP joints in 70-90 degrees of flexion
 
**** PIP and DIP joints flexed 5-10 degrees
 
***** Decreases the force exerted by the FDS
 
 
===Dispo===
 
* Refer for:
 
** Comminution
 
** Malrotation
 
** Intraarticular fx
 
** Displaced or angulated fractures that cannot maintain their reduction
 
** Most spiral and oblique fx (usually involve rotation or shortening and are unstable)
 
  
 
==[[Distal Phalanx (Finger) Fracture]]==
 
==[[Distal Phalanx (Finger) Fracture]]==

Revision as of 05:46, 4 January 2014

Background

  • Be wary of avulsion fx of base of phalanx
    • Lateral or medial fracture fragment = collateral ligament avulsion
    • Dorsal fracture fragment = extensor tendon avulsion
    • Palmar fracture fragment = volar plate avulsion
  • Flexion deformity of distal phalanx (mallet/baseball finger) = avulsion fx or extensor tendon rupture

Proximal Phalanx (Finger) Fracture

Middle Phalanx (Finger) Fracture

Distal Phalanx (Finger) Fracture

Examination

  • Evaluate for tendon damage

Imaging

  • Comminuted tuft fx
    • Stable
  • Longitudinal fx
    • Usually non-displaced and stable
  • Transverse fx
    • Evaluate for angulation/displacement
  • Intraarticular fx

Treatment

  • Nondisplaced: Splint with the DIP joint in extension (splint should extend past the tip of the distal phalanx
    • Do not attempt to reduce comminuted tuft fx

Dispo

  • Refer for:
    • Tendon dysfunction
    • Nerve dysfunction
    • Displacement or angulation
    • Intraarticular fx

See Also

Source

UpToDate