Surgery for nailbed repair and/or Kirschner wire fixation will be required in more complex cases. Finger anatomy, other common finger injuries, and thumb injuries are reviewed separately. Usually, it occurs when one end of an extremity is fixed. Extensive wound irrigation, antibiotic cover, and tetanus booster prophylaxis must be considered to mitigate this risk. Fractures of the middle phalanx are discussed here. A spiral fracture is caused when a rotating force (torque) is exerted along the axis of a long bone. A mallet splint is often used in these cases.įractures at the base of the distal phalanx are often unstable due to the fact these are the insertions sites for both the flexor and extensor tendon, however splinting of these fractures, granted they are closed has favorable outcomes 3.Īs in all cases of trauma, the importance of recognition of open distal phalanx fractures is due to the increased risk of contamination and, hence, infection. Closed fractures are generally stable, especially when they do not involve the articular surface. A Fracture of the 5th mettacarpal represents 10 of all hand fractures and is the most common bone to be injured when throwing a punch. Follow-up x-rays are obtained to see how the fracture is healing, and to evaluate for displacement. Sometimes buddy-taping to the uninjured, neighboring finger can be used in stable fractures. Treatment in these cases is typically rest and protection of the fracture with a splint for a few weeks. The majority of distal phalanx fractures are minimally displaced and may be treated conservatively. A Boxer’s fracture is a fracture of the 5th metacarpal neck (metacarpal bone of the littlefinger or pinky finger), in which direct trauma is applied to a clenched fist when it strikes another object. These patients usually do not need surgery. Fractures with significant radiological comminution and/or extensive soft tissue injury should be clinically and radiologically reviewed for open fracture. The presence or absence of an intra-articular component, degree of comminution, and fracture displacement should be assessed when formulating a report.įracture rotation can be difficult to assess radiologically and is best assessed on clinical examination. Crush injuries to the distal phalanx are also common and can result in nail trauma and open fractures. They often result from direct trauma to the finger (e.g. Plain radiographs form the mainstay of imaging distal phalanx fractures. Phalanx fractures can be intra or extra-articular and can occur at the base, neck, shaft or head of the phalanx. When associated with a crush injury, open fracture is more likely. They are frequently related to sports, with lesions such as the mallet finger and the Jersey finger. In this video, you’ll see me fix a pinky finger fracture by pinning it with stainless steel wires.The wires have sharp tips and go through the skin without a. It occurs due to a rotational, or twisting. They represent > 50% of all phalangeal fractures and frequently involve the ungual tuft 1. Causes Diagnosis Treatment Outlook What is a spiral fracture A spiral fracture, also known as torsion fracture, is a type of complete fracture. Distal phalanx fractures are among the most common fractures in the hand.
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