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Fracture, Middle Phalanx, Sports Medicine

Michael M. Linder, MD, CAQSM and Andrew M. Warner, MD Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Represents ~5% of all metacarpal and phalangeal fractures 1

  • Shaft is the most common location for fracture.

  • Physeal fractures often occur in skeletally immature individuals.

ETIOLOGY AND PATHOPHYSIOLOGY

DIAGNOSIS

HISTORY

Mechanism of injury: 
  • Grabbing a jersey, jammed finger, crush, traction, or twisting

  • Document occupation and hand dominance.

  • Probe for initial deformity or excessive blood loss.

PHYSICAL EXAM

TREATMENT

  • Open, unstable, spiral, comminuted, or those that fail to maintain reduction require orthopedic referral 2.

  • Fractures at the base 2:

    • Axial load injury common inciting mechanism

    • Nondisplaced fra...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Repeat radiographs at 2 wk may add to follow-up.

  • Deformity may result from no treatment, improper reduction, or poor splint compliance.

  • Stiffness may result from ov...

REFERENCES

1
Koval KJ, Zuckerman JD. Handbook of Fractures. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2015.
2
Eiff MP, Hatch RL. Fracture Management for Primary Care. 3rd ed. Philadelp...

ADDITIONAL READING

Birrer RB, Griesemer BA, Cataletto MB, eds. Pediatric Sports Medicine for Primary Care. Philadelphia, PA: Lippincott Williams & Wilkins; 2002. 

CLINICAL PEARLS

  • All fractures require AP, lateral, and oblique views in isolation of affected digit.

  • Splinting and buddy taping remain mainstay of nondisplaced, closed, middle phalangeal fractures, wit...

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