Proximal phalanx (finger) fracture

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

• Non-thumb metacarpal fractures
  • Head
  • Neck
  • Shaft
  • Base
  • Boxer's fracture
• Thumb fracture
• Finger (Phalanx) Fracture
  • Proximal
  • Middle
  • Distal

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
• Displaced or angulated fx
  • Consider closed reduction
    • After reduction ensure that PIP joint is in extension, MCP is in flexion (to avoid contracture)

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

• Finger (Phalanx) Fracture
• Hand Diagnoses (Main)

Source

UpToDate