Finger (phalanx) fracture: Difference between revisions

Revision as of 05:46, 4 January 2014

Be wary of avulsion fx of base of phalanx
- Lateral or medial fracture fragment = collateral ligament avulsion
- Dorsal fracture fragment = extensor tendon avulsion
- Palmar fracture fragment = volar plate avulsion
Flexion deformity of distal phalanx (mallet/baseball finger) = avulsion fx or extensor tendon rupture

Nondisplaced: Splint with the DIP joint in extension (splint should extend past the tip of the distal phalanx
- Do not attempt to reduce comminuted tuft fx

Refer for:
- Tendon dysfunction
- Nerve dysfunction
- Displacement or angulation
- Intraarticular fx

UpToDate

Authors:

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 ==[[Middle Phalanx (Finger) Fracture]]==
-* 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
-* 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 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
-===Dispo===
-* 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)
 ==[[Distal Phalanx (Finger) Fracture]]==