Distal phalanx fracture

Distal phalanx fractures are the most common fractures in the hand. 

They represent >50% of all phalangeal fractures and frequently involve the ungual tuft 1.

They are frequently related to sports, with lesions such as the Mallet finger and the Jersey finger, or can occur after a crush injury, with an increased risk of open fracture.

Radiographic features

The fracture is usually evident on radiographs. Associated soft tissue injury should be examined for signs of open fracture.

Oblique or spiral fractures may be associated with malrotation. No malrotation is acceptable for phalangeal fractures, because this leads to malalignment of the digit.2

Treatment and prognosis

The majority of distal phalanx fractures are non-displaced and can be treated conservatively. Closed fractures are generally stable, especially when they do not involve the articular surface. 

Open fractures with or without ungual trauma must be repaired carefully and sometimes need pinning with a Kirschner wire (K-wire), nail bed suture or replacement of the nail. Antibiotic therapy and tetanus prophylaxis is indicated.

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Article information

rID: 41775
Synonyms or Alternate Spellings:
  • Phalangeal tuft fracture
  • Distal phalangeal fracture

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Cases and figures

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    Case 1: distal phalanx near-amputation
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    Case 2: with wrist fractures
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    Case 3: open Salter Harris type 1
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    Case 4 : thumb distal phalanx fracture
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    Case 5
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