Review of Hand Distal Phalanx Fractures Introduction Fractures of the distal phalanx can be divided into the base, shaft, and tuft and are typically managed non-operatively.
Review of Hand Distal Phalanx Fractures Fractures of the distal phalanx can be divided into the base, shaft, and tuft and are typically managed non-operatively. Distal phalanx fractures are commonly seen during football season. The distal phalanx is made up of the base, shaft, and tuft.
Both sides of the distal phalanx are flanked by the lateral interosseous ligament and there is also a collateral ligament surrounding the distal interphalangeal joint. There are also insertions of the flexor digitorum profundus and extensor tendon. The FDP inserts on the volar and proximal aspect of the phalanx, while the extensor tendon is on the dorsal and proximal portion of the phalanx.
Fractures of the distal phalanx are typically painful due to high amount of sensory nerves present along the distal phalanx. Most fractures of the distal phalanx are secondary to crush injuries. Case Vignette You are evaluating a 23 year old patient with a finger injury in your clinic.
He states it got crushed while he was changing a tire on his car. Statistically, which fracture is he most likely to have on his distal phalanx? A) Tuft B) Shaft C) Intra-articular D) Base Labeled xray of the distal phalanx Diagnosis Physical exam of a hand injury starts with evaluation of the soft tissue for swelling and bruising.
The digit should also be evaluated for shortening and rotation. Asking the patient to actively flex their fingers into a fist will assess for rotational deformity. Neurovascular assessment for arterial and nerve injury should also be assessed with light touch and checking the pulses.
If you are experiencing symptoms that may be related to distal phalanx fractures, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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