Hand - Phalanx Fractures

Question 1

What physical exam findings should you look for in phalanx fractures

Answer 1

scissoring - may indication rotational component
Look for any open fractures
Assess neurovascular structures

Question 2

In proximal phalanx fractures what deformity may be seen and why

What about in proximal middle phalanx?

Answer 2

Apex volar angulation is seen in proximal phalanx fractures due to the proximal fragment being pulled into flexion by the interossei, and the distal fragment pulled into extension by the central slip

In proximal middle phalanx fractures there will be apex volar angulation if distal to FDS insertion and apex dorsal if proximal to FDS insertion