Distal Phalanx #s

Question 1

Closed tuft #s

Answer 1

• Rarely req splinting
• Hairpin splint (around top of finger w anchor between DIP & PIP - so metal tip protects finger tip).
• Short volar splint if needed

Question 2

Nail bed lac

Answer 2

• req Ortho review

Question 3

Management

Answer 3

Closed reduction maybe be attempted: dorsal traction in the distal fragment, followed by immobilisation in volar splint & repeat X-rays.
Open #s - ortho referral

Question 4

Complications

Answer 4

• prolonged morbidity with soft tissue crush injuries

Question 5

Base of distal phalynx #

Answer 5

• may be associated with tendon avulsion
• flexor profundus tendon attaches to volar aspect of index, middle, ring & little fingers
• terminal slip of extensor tendon attached to the dorsal surface of the distal phalynx
• thumb: flexor pollicis longus on volar base, extensor pollicis longus on dorsal base
• clinically; loss of function evident & may be visible on radiographs
• considered intra-articular & managed per other tendon injuries