Presentation
Injury to the ring finger while closing the door resulting in pain, swelling and a small wound over the nail.
Patient Data
A fracture of the phalangeal tuft is seen with associated soft tissue swelling.
Artifact seen is dressing material.
Significant osseous anatomy of the distal phalanx is; tuft, shaft, base and the distal interphalangeal joint.
Case Discussion
Phalangeal fractures are the most common injuries of the skeletal system accounting for up to 10% of all fractures. The incidence is greater in distal phalanx>middle phalanx>proximal phalanx.
Tuft fractures are usually as a result of crush injury and are usually stable due to presence of nail plate on the dorsum and pulp on the volar aspect of the fingertip. They are occasionally associated with laceration of the pulp or nail matrix.
Due to this stability, most fractures are managed conservatively. In severe cases, a K-wire may be used to immobilize.
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