Thumb ORIF

Case contributed by Amanda Er
Diagnosis certain


Left thumb caught in car door 4 days ago. Open reduction and internal fixation performed 2 weeks after initial presentation.

Patient Data

Age: 60 years
Gender: Male

Initial presentation


On the left thumb, a displaced fracture involving the shaft of the proximal phalanx is noted, without any obvious intra-articular extension.

Post operative


Interval surgical fixation of the first proximal phalanx fracture, with bony alignment as shown. There is no periprosthetic fracture, however, adjacent soft tissue swelling is noted.

Case Discussion

This patient sustained a proximal phalanx fracture on their left thumb. He had originally undergone closed reduction, but the outcome was not ideal. An open reduction internal fixation (ORIF) was carried out instead, with the images showing satisfactory alignment.

Phalanx fractures are commonly the result of crush injuries, as is the case with this patient. Depending on the location and type of the fracture, the prognosis and treatment is different. Hence, it is important that orthogonal views are obtained at the initial presentation, to assist in operative planning.

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