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Fracture, Proximal Phalanx, Sports Medicine

James H. Lynch, MD, MS, FACSM and Gary Means, MD Reviewed 04/2019
 


BASICS

EPIDEMIOLOGY

  • The most common fracture of the hand in adults

  • Base of proximal phalanx fracture is most common pediatric hand fracture.

  • Little finger is the most common ray involved, followed by the...

DIAGNOSIS

HISTORY

  • Mechanism of injury: direct blow, axial load, axial traction, twisting/torque, or “grabbing a jersey”

  • History of previous injury, surgery, or deformity

PHYSICAL EXAM

  • Pain, swelling, brui...

TREATMENT

  • Open (compound) fractures: irrigation, sterile wet dressing, ice, elevate, splint, refer to orthopedic surgeon:

    • Prophylactic antibiotics should be administered 2[A].

    • Empiric antibiotics to cov...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

On follow-up x-rays, any malalignment should prompt an orthopedic surgeon consultation. 

Patient Monitoring

Monitor specific fractures as follows 6[B]: 
  • Stable, nond...

REFERENCES

1
Aksay E, Kilic TY, Yesilaras M, et al. Accuracy of bedside ultrasonography for the diagnosis of finger fractures. Am J Emerg Med.  2016;34(5):809–812.
2
Gosselin RA, Roberts I, Gillespi...

ADDITIONAL READING

  • Cornwall R, Ricchetti ET. Pediatric phalanx fractures: unique challenges and pitfalls. Clin Orthop Relat Res.  2006;445:146–156.

  • Giddins G. The nonoperative management of hand f...

CLINICAL PEARLS

  • Return-to-play decision based on stability, ROM, current clinical and radiographic healing status, and specific demands of sport

  • Most athletes with stable fractures are able to return a...

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