Hand and finger fractures
Background
Hand and Finger Fracture Types
Clinical Features
- History of trauma
- Pain over fracture site
Differential Diagnosis
Hand and finger injuries
- Distal finger
- Other finger/thumb
- Boutonniere deformity
- Mallet finger
- Jammed finger
- Jersey finger
- Trigger finger
- Ring avulsion injury
- De Quervain tenosynovitis
- Infiltrative tenosynovitis
- Metacarpophalangeal ulnar ligament rupture (Gamekeeper's thumb)
- Hand
- Wrist
- Drummer's wrist
- Ganglion cyst
- Lunotriquetral ligament instability
- Scaphoid fracture
- Extensor digitorum tenosynovitis
- Compressive neuropathy ("bracelet syndrome")
- Intersection syndrome
- Snapping Extensor Carpi Ulnaris
- Vaughn Jackson syndrome
- General
Evaluation
Workup
- XR hand and/or finger(s)
- Consider need for more proximal or distal plain films
Diagnosis
Management & Disposition
Hand Fracture Management Chart
Fracture | Splint | Disposition |
Flexor tendon injury | Finger Splint | hand specialist referral |
Extensor tendon injury | Poss ED repair + Finger Splint | hand specialist referral |
Mallet finger | Finger Splint to DIP (DIP in slight hyperextension) | |
Metacarpophalangeal ulnar ligament rupture (Gamekeeper's thumb) | Thumb Spica Splint | |
Scaphoid fracture | Thumb Spica Splint | |
Carpal fracture | Volar Splint | |
Bennet's fracture (intrarticular fracture at base of 1st MCP) | Thumb Spica Splint | |
Rolando's fracture (comminuted base of 1st MCP) | Thumb Spica Splint | |
Boxer's fracture | Ulnar Gutter Splint | |
4th and 5th MCP fracture | Ulnar Gutter Splint | |
2nd and 3rd MCP fracture | Radial Gutter Splint | |
Finger (Phalanx) Fracture | Finger Splint or Buddy Tape |