Middle phalanx (finger) fracture: Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - "fx " to "fracture ") |
Neil.m.young (talk | contribs) (Text replacement - "* " to "*") |
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==Background== | ==Background== | ||
* Commonly associated with tendon injuries! | *Commonly associated with tendon injuries! | ||
==Examination== | ==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== | ==Images== | ||
* AP, lateral, oblique | *AP, lateral, oblique | ||
* Oblique and spiral fractures: evaluate for shortening/malrotation | *Oblique and spiral fractures: evaluate for shortening/malrotation | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Treatment== | ==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 [[Finger Splint]] if desire added protection | **Dorsal or volar [[Finger Splint]] if desire added protection | ||
* Displaced or angulated fx | *Displaced or angulated fx | ||
** Closed reduction | **Closed reduction | ||
*** Adequate reduction: | ***Adequate reduction: | ||
**** <1-2mm displacement or shortening | ****<1-2mm displacement or shortening | ||
**** Up to 10 degrees of angulation | ****Up to 10 degrees of angulation | ||
**** No amount rotation | ****No amount rotation | ||
*** Followed by [[Ulnar Gutter Splint]] or [[Radial Gutter Splint]] | ***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 | ||
**** PIP and DIP joints flexed 5-10 degrees | ****PIP and DIP joints flexed 5-10 degrees | ||
***** Decreases the force exerted by the FDS | *****Decreases the force exerted by the FDS | ||
==Disposition== | ==Disposition== | ||
* Refer for: | *Refer for: | ||
** Comminution | **Comminution | ||
** Malrotation | **Malrotation | ||
** Intraarticular fx | **Intraarticular fx | ||
** 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) | ||
==See Also== | ==See Also== | ||
Revision as of 22:33, 7 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
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 fracture (usually involve rotation or shortening and are unstable)
See Also
References
UpToDate