Phalanx #
INTRODUCTION
INTRODUCTION
- Most common upper limb fractures (1)
- Divided into (2,3):
- Proximal phalanx
- Often comminuted and involving the MCPJ.
- Neck fractures tend to be unstable.
- Middle phalanx
- Middle # tend to be stable due to FDS insertion.
- Proximal # tend to have a poor functional outcome.
- Distal phalanx
- Most common phalanx #, especially the middle finger and the thumb
- Nail plate/bed commonly involved
- Be wary of injuries to the flexor/extensor tendon
- Proximal phalanx
- Most common mechanism of injury:
- Children: Shut in door
- Adult: Workplace injury or sports
- Phalangeal fractures for conservative management (1):
- If affects only the tuft of distal phalanx
- Phalangeal fractures requiring MUA or Surgery :
- Rotational deformity
- Significant dorsal angulation
- Radial or ulnar angulation +/- scissoring
- Open or intra-articular fractures
- Fractures with bone loss or associated NV/tendon injury
ASSESSMENT
ASSESSMENT
REFERENCES
REFERENCES
1. Haughton D, Jordan D, Malahias M, Hindocha S, Khan W. Principles of hand fracture management. Open Orthop J. 2012;6:43–53. 2. Green DP, Wolfe SW. Green’s operative hand surgery. Elsevier/Churchill Livingstone; 2011. 3. Chiu TW. Stone’s Plastic Surgery Facts: A Revision Guide, Fourth Edition. CRC Press; 2018. 4. The British Society of Surgery for the Hand. Hand Injury Triage App [Internet]. [cited 2020 Feb 2]. Available from: handinjurytriageapp.bssh.ac.uk
Header Image: Licensed with Adobe Stock 2019
Header Image: Licensed with Adobe Stock 2019
This subpage has been reviewed by:
1) Mr. Martin Shapev - Plastic Surgery Registrar, RD&E (06/02/2020)
1) Mr. Martin Shapev - Plastic Surgery Registrar, RD&E (06/02/2020)