PHALANX FRACTURE

Question 1

Distal Phalanx Fracture Mechanism

Answer 1

Crush
Shear

Question 2

Distal Phalanx Fracture Classification

Answer 2

Tuft
Shaft
Intra-articular

Question 3

Distal Phalanx Associated injuries

Answer 3

Nailbed injury
Flexor or Extensor tendon injury

Question 4

Physical Exam

Answer 4

Always check for rotation
Nailbeds should be parallel and point to scaphoid

Question 5

XRAY Findings

Answer 5

Anatomic Transverse = stable
Unstable = oblique, diplaced, angulated, rotated

Question 6

ED Management: Stable / Non displaced
Middle / Proximal Phalanx

Answer 6

buddy tape or dynamic splinting ~ 3 weeks

Question 7

ED Management: Unstable Middle / Proximal Phalanx

Answer 7

Radial / Ulnar Gutter
90 degree MCP flexion
15 - 20 degree PIP flexion
5 degree DIP flexion

Question 8

Long term management

Answer 8

Cast / Splint for 3 weeks
Removable splint 3 weeks (reading, writing, arithmetic)
Light strengthening / protected activity for 6 weeks
NO SPORTS / HEAVY LIFTING FOR 3 months total