Distal Phalanx Fracture – What You Need to Know
Fractures are hard to avoid during traumatic injuries plus, they could occur anywhere in the body. There are certain locations in our body where certain unexpected and low-energy events can result in fractures. One such location that will be discussed in this post is the distal phalanx or fingertip.
The distal phalanx is known to be one of the most commonly fractured bones in the human hand. It is noticed that fractures in the fingertips generally occur due to crush injuries and that also results in the injury to soft tissues. Fracture to the distal phalanx can be noticed with the clinical examination as it will show swelling on the fingertip along with pain even with a slight touch.
These fractures are generally treated without surgery using a splint. But in certain complicated cases, surgery using trauma implants may be required.
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Causes of Distal Phalanx Fracture
The most common mechanisms of the fracture to the fingertip are blunt trauma or crush injuries. Such fractures are generally due to sports or work-related injuries. Plus, soft-tissue damage is also seen in these cases. In the case of excessive tissue damage, nail bed laceration may also be seen.
Fingertip fractures can be of three types including longitudinal, transverse, and comminuted. Comminuted distal phalanx fractures are hard to treat and for these fractures, splinting may be used after molding the fractured bone fragments.
Diagnosis of Distal Phalanx Fracture
During the diagnosis of fingertip fractures, the examination of the motion of the distal interphalangeal joint (DIPJ) will be done first to know the symptoms. After this, the orthopedist will suggest a radiological examination preferably an X-ray. To determine the fracture pattern, a three-view radiograph may be indicated i.e. AP, lateral, and oblique. Based on these examinations, the orthopedist will be able to get a clear idea of the severity of the fracture and decide which treatment procedure will be the best.
Management of Distal Phalanx Fracture
The severity of the fracture will decide what type of treatment procedure will be followed. If we talk about open fractures, then such cases are serious and may require emergency treatment. In open fractures, extensive cleaning and debridement are also required. To avoid any infections, antibiotics are also prescribed. In most cases, open distal phalanx fractures can be fixed with the application of aluminum splint for around 4 to 6 weeks.
For significantly displaced or angulated fractures, closed reduction may be done.
In the case of intra-articular fractures where one-third or more than the one-third articular surface is involved, surgery may be required. For surgery, Orthopaedic Trauma Implants like Bone Plates, Bone Screws, or K-Wires may be required.
Most distal phalanx fractures can be treated with non-operative treatment procedures and often involve the application of a splint. Besides splinting, taping may also be done for providing support and ensuring proper immobilization of fractured bone fragments.