Phalanx Fracture

Phalangeal Fracture
Phalangeal Fractures
Distal
Phalanx:
Extra-articular fractures are common, associated

with significant soft tissue injury.
Crush injuries from a perpendicular force (injuries
from a car door or hammer)
Intra-articular fractures are associated with extensor

tendon avulsion (Mallets finger), FDP tendon
avulsion (Jersey finger).
Examination:
Inspection:.
Neurovascular status should be examined.
Palpation is done for tenderness.
Closed treatment is recommended with splinting

and if necessary closed reduction
Middle
Phalanx:
Blunt or crush force perpendicular to the long axis of the

bone.
Angulation and rotation are two features of instability
that must be examined.
Rotational deformities are serious injuries and are
detected clinically.
Examination:
Inspection: for dislocations and sublaxations. Ask patient to fully
flex the phalanx to examine alignment of digits.
Palpation: swelling and tenderness
Treatment:
Nondisplaced without impaction: require only dynamic splinting
for 2-3 weeks.
Angulation and rotation require closed reduction and splinting to
restore finger alignment.
Proximal
Phalanx:
More common than middle phalanx fractures.

May result in a great deal of disability.
Dorsal or palmar angulation may occur with these
fractures.
Examination:
Inspection:
Neurovascular status
Palpation is done for tenderness.
Treatment:
Nondisplaced fractures: usually stable and treated by
closed reduction and dynamic splinting.
Angulated or unstable fractures may require internal or
external fixation.
4
PHALANGEAL FRACTURES
FRACTURES OF DISTAL PHALANX

Classificatuion:1)tuft #
simple #
comminuted#
Shaft #---transversestable or unstable
----longitudinal
Articular#---volar, epiphyseal,dorsal
dr sumer yadav, mch plastic surgery.

sumeryadav2004@gmail.com

TREATMENT OF DISTAL PHALANGEAL #
TUFT #-drain subungual hematoma

finger splint
Shaft #-- CRIFk-wire
Epiphyseal #--ORIF
Complications nonunion
-malunion

FRACTURES OF MID & PROXIMAL PHALANX
ARTICULAR #(london)--1)condylar #
Type1-stable #without displacement
Type2-unicondyle,unstable
Type3-bicondyle,comminuted















UNICONDYLAR FRACTURES
Classification-Weiss &Hastings
Class1-oblique volar
Class2-longsaggital
Class3-dorsal coronal
Class4-volarcoronal
Treatment-CRIF OR ORIF with k-wire or screws
AT 5-7DAysarom, splint PIP in full extension
Remove k wires 3-4 weeks

TREATMENT OF BYCONDYLAR FRACTURES
ORIF WITH PLATES & SCREWS

Dynamic splint
External fixation
Interfragmentary screws

PSEUDOBOUTTONOUIRE DEFORMITY
IN FRACTURES OF HEAD OF PHALANX WHEN

THERE IS DISPLACED collateral ligamentous
injury & healing occurs ,when there is adhesions
between the adjacent lateral band,& oblique
retinacular ligament& volar plate

Other fractures of head of phalanx
1)avulsion # of dorsal base of mid phalanx>detachment of central tendon insertions a

result of ant pip jt dislocation
Treatment- ORIF

CONT.
#lateral base of proximal or mid phalanxit

represents collat ligament avulsion
Treatment-a) uncomplicatedsplint for 10-14
days
B) complicatedORIF with k-wire
# BASE OF PROXIMAL PHALANXTreatment-ORIF

Cont
SHAFT # INVOLVING JOINTTreatment ORIF

Proximal traction phalanx splintnoninvasive, minimal stiffness, comminuted#

NECK FRACTURES
Common in toddlers
Classification->type1-nondisplaced
type2-displaced with some bone contact
Type3-completely displaced
Treatment-ORIF with k-wire or

SHAFT FRACTURES
They can be transverse, oblique, spiral,

comminuted
Treatment
1)nondisplaced & stable-cock-up position
2)displaced-stable after CR-cock-up position slab
Displaced unstable after reductionA) spiral &oblique-CR& IF with kwire

CONT
Transverse#-ORIF with kwire& intra osseous wire

Displaced unstable & comminuted-external
fixation,miniplate & screws

COMPLICATIONS OF PHALANGEAL FRACTURES
MALUNION-classified-a) malrotation,volar
angulation,lateral angulation,
It is usually seen after oblique or spiral #
Treatment-osteotomy with plate
fixation,lateralwedge osteotomy,corrective
osteotomy

CONT
Intrarticular malunion
Nonunion
Loss of motion
Pip joint extensor lag
infection

Fractures of the thumb bones

Fractures of phalanx-a) extra articular
B) Intra articular
EXTRA ARTICULAR-1)distalplongitudnal,transervse,tuft
Treatment-repair of dermal nail matrix, application
of splint,CRIF WITH k wire, ORIF with k wire





FRACTURES OF PROXIMAL PHALANX
Head & neck#-CRIF WITH K WIRE

ORIF WITH K WIRE
Angulation of 20-30* is unacceptable





Intraarticular # & avulsion
1)dorsal base of distal phalanx-mallet thumb

Treatment-external splint
2)ulnar base of proximal phalanx-game keeper
thumb
Treatment-reinsertion of collateral ligament or
CRIF with k wire

thank you


Phalanx Fracture

Transféré par

Informations du document

Copyright

Formats disponibles

Partager ce document

Partager ou intégrer le document

Options de partage

Avez-vous trouvé ce document utile ?

Ce contenu est-il inapproprié ?

Droits d'auteur :

Formats disponibles

Phalanx Fracture

Transféré par

Droits d'auteur :

Formats disponibles

Phalangeal Fracture

Extra-articular fractures are common, associated

Intra-articular fractures are associated with extensor

Closed treatment is recommended with splinting

Blunt or crush force perpendicular to the long axis of the

More common than middle phalanx fractures.

FRACTURES OF DISTAL PHALANX

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

TREATMENT OF DISTAL PHALANGEAL #

TUFT #-drain subungual hematoma

dr sumer yadav, mch plastic surgery.

FRACTURES OF MID & PROXIMAL PHALANX

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

TREATMENT OF BYCONDYLAR FRACTURES

ORIF WITH PLATES & SCREWS

dr sumer yadav, mch plastic surgery.

IN FRACTURES OF HEAD OF PHALANX WHEN

dr sumer yadav, mch plastic surgery.

Other fractures of head of phalanx

1)avulsion # of dorsal base of mid phalanx>detachment of central tendon insertions a

dr sumer yadav, mch plastic surgery.

#lateral base of proximal or mid phalanxit

dr sumer yadav, mch plastic surgery.

SHAFT # INVOLVING JOINTTreatment ORIF

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

They can be transverse, oblique, spiral,

dr sumer yadav, mch plastic surgery.

Transverse#-ORIF with kwire& intra osseous wire

dr sumer yadav, mch plastic surgery.

COMPLICATIONS OF PHALANGEAL FRACTURES

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

Fractures of the thumb bones

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

FRACTURES OF PROXIMAL PHALANX

Head & neck#-CRIF WITH K WIRE

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

dr sumer yadav, mch plastic surgery.

Intraarticular # & avulsion

1)dorsal base of distal phalanx-mallet thumb