Middle phalanx fracture

Last revised by Jeevan K Karuppannan on 21 Feb 2024

Middle phalanx fractures are the least common of the phalanx fractures.

Radiographic features

These fractures are generally well visualized on plain radiographs. Ultrasonography can be used in unclear cases.

Treatment and prognosis

Non-displaced fractures can be treated conservatively with a palmar or dorsal splint fixating the interphalangeal joints for a period of 2 to 3 weeks. It should not be longer to avoid the interphalangeal joints to become stiff, and because the majority of fractures are stable.

Displaced fractures or open fractures are treated surgically with fixation by Kirchner wires or very small screws.

Proper identification and early referral to a hand surgeon can limit potential long-term complications that arise from avascularisation4.

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Cases and figures

  • Case 1
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  • Case 2: open fracture
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  • Case 3: avulsion fracture at base of middle phalanx
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  • Case 4: minimally displaced
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  • Case 5: undisplaced 4th and 5th middle phalanx fracture
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  • Case 6: with dislocation
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