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Phalangeal Injuries, Hand, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • 1/3 of all traumatic injuries affect the hand.

  • Phalanges account for 1 of the most frequently fractured parts of the skeletal system with the distal phalanx being the most commonly fr...

Diagnosis

Signs and Symptoms

History

  • Mechanism of injury:

    • Hyperextension injuries most commonly cause ligamentous injury (e.g., “Jersey finger” which is a rupture of the flexor digitorum profundus tendon...

Treatment

Pre-Hospital

  • Reduction of a phalangeal dislocation at the scene SHOULD NOT be considered UNLESS there will be an unusually long transport time or there is vascular or neurologic compromise.

    • Re...

Follow-Up

Disposition

  • Patients with a stable injury, in an appropriate splint, may be discharged for orthopedic follow-up and possible repeat imaging in 1 wk time.

Emergent orthopedic consult is require...

Pearls and Pitfalls

  • Rotational deformity may not be apparent if finger is straight, exam under flexion is required.

  • Jersey finger (FDP tendon rupture) is often misdiagnosed as a “jammed” or sprained fi...

Additional Reading

  • Oetgen  ME, Dodds  SD. Non-operative treatment of common finger injuries. Curr Rev Musculoskelet Med.  2008;1:97–102.

  • Okike  K, Bhattacharyya  T. Trends in the management of ope...

Codes

ICD9

  • 816.00 Closed fracture of phalanx or phalanges of hand, unspecified

  • 834.00 Closed dislocation of finger, unspecified part

  • 959.5 Finger injury

  • 883.0 Open wound of finger(s), without mention of c...

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