Middle phalanx (finger) fracture: Difference between revisions
(Created page with "* Commonly associated with tendon injuries! ===Examination=== * Assess PIP, DIP flexion/extension * Assess PIP, DIP collateral ligaments (varus/valgus stress) ===Images=== *...") |
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==Background== | |||
* Commonly associated with tendon injuries! | * Commonly associated with tendon injuries! | ||
==Examination== | |||
* Assess PIP, DIP flexion/extension | * Assess PIP, DIP flexion/extension | ||
* Assess PIP, DIP collateral ligaments (varus/valgus stress) | * Assess PIP, DIP collateral ligaments (varus/valgus stress) | ||
==Images== | |||
* AP, lateral, oblique | * AP, lateral, oblique | ||
* Oblique and spiral fractures: evaluate for shortening/malrotation | * Oblique and spiral fractures: evaluate for shortening/malrotation | ||
==Treatment== | |||
* Nondisplaced without angulation: | * Nondisplaced without angulation: | ||
** Buddy tape to adjacent finger | ** [[Buddy tape]] to adjacent finger | ||
*** Buddy tape ring finger to little finger | *** [[Buddy tape]] ring finger to little finger | ||
** Dorsal or volar | ** Dorsal or volar [[Finger Splint]] if desire added protection | ||
* Displaced or angulated fx | * Displaced or angulated fx | ||
** Closed reduction | ** Closed reduction | ||
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**** Up to 10 degrees of angulation | **** Up to 10 degrees of angulation | ||
**** No amount rotation | **** No amount rotation | ||
*** Followed by | *** Followed by [[Ulnar Gutter Splint]] or [[Radial Gutter Splint]] | ||
**** Wrist in 20-30 degrees of extension | **** Wrist in 20-30 degrees of extension | ||
**** MCP joints in 70-90 degrees of flexion | **** MCP joints in 70-90 degrees of flexion | ||
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***** Decreases the force exerted by the FDS | ***** Decreases the force exerted by the FDS | ||
== | ==Disposition== | ||
* Refer for: | * Refer for: | ||
** Comminution | ** Comminution | ||
Revision as of 05:44, 4 January 2014
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
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
- Buddy tape to adjacent finger
- 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 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 fx
- Displaced or angulated fractures that cannot maintain their reduction
- Most spiral and oblique fx (usually involve rotation or shortening and are unstable)
See Also
Source
UpToDate