Proximal phalanx fracture
Proximal phalanx fractures can be epiphyseal or shaft fractures and can be articular or extra-articular.
The fracture is generally well seen on plain radiographs. Ultrasonography can be used for fractures that are difficult to see or there are doubts.
Treatment and prognosis
The clinical consolidation is in 4 or 6 weeks; radiological consolidation takes longer. However, it should be noted that the fingers don't tolerate immobilisation very well so it shouldn't exceed 3 weeks.
Treatment can be conservative in case of a non-displaced fracture, but the method of immobilisation may vary between orthopaedic surgeons. Some use a splint in palmar or dorsal position, fixating the wrist, MCP joint and the entire finger, also immobilising the adjacent finger. Others use a cast which fixates the wrist, metacarpophalangeal joint and proximal phalanx but allows movement of the interphalangeal joints.
Surgery is required in case of an open fracture, significant displacement, and instability after reduction. Surgical fixation involves Kirchner wires or very small screws.
Wrist and hand fractures
- wrist and hand fractures (Amsterdam wrist rules)
- distal radial fracture (Frykman classification)
- distal ulna fractures
- fracture dislocations of the radius and ulna
- carpal fractures
- metacarpal fractures
- phalanx fractures