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Proximal phalanx (finger) fracture
From WikEM
Contents
Background
- The flexor digitorum superficialis (FDS) inserts at the middle of the phalanx and can cause rotational deformity[1]
- Extensor tendons and interosseous muscles commonly causes volar angulation[1]
Clinical Features
- Finger pain
Differential Diagnosis
Hand and Finger Fractures
Evaluation
Physical
- Examine the phalanx with the fingers in full extension and flexion
- Assess for malrotation
Imaging
- AP, lateral, oblique
- Examine for rotation, shortening, angulation
Management
- If requires ortho referral: Radial gutter splint or ulnar gutter splint[1]
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
- Dorsal or volar Finger Splint if desire added protection
Displaced or angulated fracture
- 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 fracture
- Condylar fracture
- Neck fracture
- Large avulsion fracture
- Rotated
- NO degree of rotation is acceptable following a reduction
- Shortened
- Significantly angulated
- Less than 10 degrees may be tolerated
See Also
References
- ↑ 1.0 1.1 1.2 German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.
Authors
Ross Donaldson, Ted Fan, Jonathan Snyder, Neil Young, Daniel Ostermayer
