Thumb proximal phalanx avulsion fracture

Case contributed by Derek Smith
Diagnosis certain


Fall 24 hours previously onto outstretched hand. "Snapping" sound at time of fall. Tender anatomical snuff box and thumb tenderness on telescoping.

Patient Data

Age: 30 years
Gender: Female

Scaphoid views


Scaphoid views: no scaphoid or carpal injury, normal distal radius

There is an avulsion fracture at the base of the thumb proximal phalanx.

Dedicated thumb views


Dedicated thumb views confirm the volar avulsion fracture of the proximal phalanx.

Case Discussion

Another example of the importance of reviewing the edge of the film for unexpected findings. No scaphoid fracture is present, but the avulsion fracture of the proximal phalanx certainly fits with the history and findings.

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