Phalangeal tuft fractures

Case contributed by Dr Matt A. Morgan

Presentation

Hand vs snowblower

Patient Data

Age: 40-45Y
Gender: Male
X-ray

Comminuted fractures of the second and third distal phalanx / phalangeal tufts. No intra-articular extension to the DIP joint. The comminuted fragments of the third digit phalangeal tuft fracture and somewhat displaced. Marked swelling of the distal third digit.

On exam, there were complex lacerations nail matrix and the germinal matrix in both fingers. A large fragment of the distal phalanx extended dorsally out of the third digit nail. 

X-ray

Zoomed-in images

Zoomed in images.

Case Discussion

Distal phalanx fractures and phalangeal tuft fractures constitute almost 50% of all hand fractures 1.

Dense fibrous connections in the distal digit around the phalangeal tuft mean that most phalangeal tuft fractures are stable and amenable to closed treatment. Many are managed non-operatively with splinting, but very comminuted fractures may require K-wire stabilization 2.

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Case information

rID: 48241
Case created: 26th Sep 2016
Last edited: 27th Sep 2016
Inclusion in quiz mode: Excluded

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