Middle phalanx (finger) fracture: Difference between revisions
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***[[Buddy tape]] ring finger to little finger | ***[[Buddy tape]] ring finger to little finger | ||
**Dorsal or volar [[Finger Splint]] if desire added protection | **Dorsal or volar [[Finger Splint]] if desire added protection | ||
*Displaced or angulated | *Displaced or angulated fracture | ||
**Closed reduction | **Closed reduction | ||
***Adequate reduction: | ***Adequate reduction: | ||
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**Comminution | **Comminution | ||
**Malrotation | **Malrotation | ||
**Intraarticular | **Intraarticular fracture | ||
**Displaced or angulated fractures that cannot maintain their reduction | **Displaced or angulated fractures that cannot maintain their reduction | ||
**Most spiral and oblique fracture (usually involve rotation or shortening and are unstable) | **Most spiral and oblique fracture (usually involve rotation or shortening and are unstable) | ||
Revision as of 10:45, 10 July 2016
Background
- 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
Differential Diagnosis
Hand and Finger Fracture Types
Management
- Nondisplaced without angulation:
- Buddy tape to adjacent finger
- Buddy tape ring finger to little finger
- Dorsal or volar Finger Splint if desire added protection
- Buddy tape to adjacent finger
- Displaced or angulated fracture
- Closed reduction
- Adequate reduction:
- <1-2mm displacement or shortening
- Up to 10 degrees of angulation
- No amount rotation
- Followed by Ulnar Gutter Splint 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
- Adequate reduction:
- Closed reduction
Disposition
- Refer for:
- Comminution
- Malrotation
- Intraarticular fracture
- Displaced or angulated fractures that cannot maintain their reduction
- Most spiral and oblique fracture (usually involve rotation or shortening and are unstable)
See Also
References
UpToDate