Finger (phalanx) fracture

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

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

• Fractures (Main)
• Hand Diagnoses (Main)

Source

UpToDate