Click the above link to see POSNA's latest updates! J Pediatr Orthop, 2001. This site needs JavaScript to work properly. The finger is ecchymotic, swollen throughout, and painful with attempted range of motion of the PIP joint. Pasa L, Kelbl M, Suchomel R, Procházka V, Filipínský J. Acta Chir Orthop Traumatol Cech.

24(7): p. 466-7. Nondisplaced phalanx fractures are managed with splint immobilization. Won SH, Lee S, Chung CY, Lee KM, Sung KH, Kim TG, Choi Y, Lee SH, Kwon DG, Ha JH, Lee SY, Park MS. Clin Orthop Surg. Petnehazy, T., et al., Fractures of the hallux in children. Smith, Epidemiology of lawn-mower-related injuries to children in the United States, 1990-2004. 36(1)p. 60-3. A 20-year-old football player presents with a one week history of right index finger pain which started after his hand got caught in a face mask during a tackle.

Toe fractures most frequently are caused by a crushing injury or axial force such as stubbing a toe. Weiss and Hastings reported on 28 patients with unicondylar fractures of the proximal phalanx and found the most common mechanism of injury was during ball-handling sports. Am Fam Physician. commonly seen with small avulsion fracture of the base of the middle phalanx; simple . A collegiate baseball player injures his left small finger sliding into third base. J AmAcad Orthop Surg, 2001. Kay, R.M. and C.W. A radiograph taken at the time of injury is shown in Figure A, and a current radiograph is shown in Figure B. Tested Concept, (OBQ11.63) Phalangeal fractures represent 3% to 7% of all physeal fractures and are usually Salter-Harris type I or type II injuries.  | 

 |  Stable, reduced phalanx fractures are immobilized but require close monitoring to ensure maintenance of fracture reduction.

NIH Van Vliet-Koppert ST, Cakir H, Van Lieshout EM, De Vries MR, Van Der Elst M, Schepers T. J Foot Ankle Surg.  |  118(2): p. e273-8. Diagnosis and Management of Common Foot Fractures. Kensinger, D.R., et al., The stubbed great toe: importance of early recognition and treatment of open fractures of the distal phalanx. Tested Concept, Proximal phalanx extraarticular fractures, Middle phalanx dorsal and palmar lip fractures (pilon), (OBQ07.218) and S. Hacking, Evaluation and management of toe fractures. Epub 2011 Mar 25. Tang, Pediatric foot fractures: evaluation and treatment. Patients with displaced fractures of the first toe often require referral for stabilization of the reduction. Hatch, R.L. USA.gov. Unexpected Salter-Harris type II fracture of the proximal phalanx of the second toe: a chiropractic perspective.

2011 May-Jun;50(3):307-10. doi: 10.1053/j.jfas.2011.02.003.

2016 Feb 1;93(3):183-91.

What is the most frequently encountered form of osseous injury associated with dorsal proximal interphalangeal joint(PIP) fracture-dislocations? Stable, nondisplaced toe fractures should be treated with buddy taping and a rigid-sole shoe to limit joint movement. Vollman, D. and G.A. Fractures of the toe are one of the most common lower extremity fractures diagnosed by family physicians. ClinPediatr (Phila), 2011. Non-displaced fractures A non-displaced fracture is a fracture where the two ends of the bone are still well aligned. Most frequently, the thumb, the middle finger, or somewhat less often, the index finger is injured. ball striking fingertip), leads to tearing of the collateral ligaments and shearing of the volar plate off of the base of middle phalanx, commonly seen with small avulsion fracture of the base of the middle phalanx, middle phalanx remains in contact with condyles of proximal phalanx, base of middle phalanx not in contact with condyle of proximal phalanx, volar plate can act as block to reduction with longitudinal traction, one of proximal phalangeal condyles buttonholes between the central slip and lateral band, reduce by applying traction to finger with MCP and PIP joints in 90° of flexion, flexion relaxes volarly displaced lateral band, allowing it to slip back dorsally, PIP flexion contracture (pseudoboutonniere), volar lip fractures are the most common fracture pattern seen with dorsal dislocations, Amount of P2 articular surface involvement, articular surface reconstruction is desirable, but not necessary for a good clinical outcome, PIP subluxation inhibits the gliding arc of the joint and leads to a poor clinical outcome, highly comminuted "pilon" fracture-dislocations, DIPJ dislocations are usually dorsal or lateral, often associated with open wounds due to tight soft tissue envelope, associated with avulsion of dorsal lip/terminal tendon, associated with avulsion of volar lip/FDP, if dorsal DIPJ dislocation, reduce with longitudinal traction, direct pressure on dorsal aspect of distal phalanx, and DIPJ flexion, perform thorough irrigation and debridement if open, tuft fractures require no specific treatment, can consider temporary splinting, and rarely may require pinning, FDP may be blocking reduction if injury is open, in volar DIPJ dislocation, terminal tendon interposition can prevent reduction, perform FDP repair if dorsal fracture-dislocation where FDP is attached to volar fragment, may require percutaneous pinning to support nail bed repair, highly comminuted injuries with significant soft tissue loss or neurovascular injury, Lunate Dislocation (Perilunate dissociation), Gymnast's Wrist (Distal Radial Physeal Stress Syndrome), Scaphoid Nonunion Advanced Collapse (SNAC), Carpal Instability Nondissociative (CIND), Constrictive Ring Syndrome (Streeter's Dysplasia), Thromboangiitis Obliterans (Buerger's disease), Common traumatic injury of the hand involving the proximal interphalangeal joint (PIP) or distal interphalangeal joint (DIP), treatment is closed reduction and splinting unless volar plate entrapment blocks reduction or a concomitant fracture renders the joint unstable, results from rupture of one collateral ligament, with the other remaining intact, results from rupture of one collateral ligament and at least partial avulsion of volar plate from middle phalanx, if simple dorsal dislocation, reduce with force directed volarly and in flexion, if complex dorsal dislocation, reduce with hyperextension of middle phalanx followed by palmar force, dorsal dislocation that is stable after reduction, in closed dorsal dislocations, reduction is usually prevented by volar plate interposition, in open dorsal dislocations, reduction is usually prevented by dislocated FDP tendon, in lateral dislocations, reduction is usually prevented by lateral band interposition, perform dorsal approach with incision between central slip and lateral band, may develop but usually resolves with therapy, PIPJ fracture-dislocations can be volar or dorsal, highly comminuted fracture may occur, known as "pilon", in dorsal PIPJ fracture-dislocations, hyperextension leads to failure of the volar plate resulting in rupture or avulsion of the middle phalangeal volar lip, in volar PIPJ fracture-dislocations, hyperflexion leads to failure of the central slip resulting in rupture or avulsion of the middle phalangeal dorsal lip, axial loading of the finger with the PIPJ in flexion or extension leads to dorsal and volar fracture-dislocations, respectively, regardless of treatment, must achieve adequate joint reduction for favorable long-term outcome, reduction of the middle phalanx on the condyles of the proximal phalanx is the primary goal, adequate volar exposure of the volar plate requires resection of. Toe fractures most frequently are caused by a crushing injury or axial force such as stubbing a toe. Toe fractures are one of the most common fractures diagnosed by primary care physicians. A 27-year-old man falls on his hand at work.

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Fractures of the toes represent the most common foot fractures in the pediatric age group and may account for as many as 18% of pediatric foot fractures.

Displaced fractures of the lesser toes should be treated with reduction and buddy taping.

Mounts, J., et al., Most frequently missed fractures in the emergency department. Fractures of the toe are one of the most common lower extremity fractures diagnosed by family physicians. Radiographs are provided in Figure A. One of the most common foot fractures in children, Open fractures require irrigation & debridement, Nail-bed injuries involving the germinal matrix should be repaired, Displaced intra-articular fractures of the hallux require reduction. Please enable it to take advantage of the complete set of features!

Want to stay updated? bayonet deformity; base of middle phalanx not in contact with condyle of proximal phalanx; volar plate can act as block to reduction with longitudinal traction ; volar dislocations .

Tested Concept, Immobilization of the distal interphalangeal joint is required for 2 weeks post-operatively, High rates of post-operative infection are common, Open reduction via an approach through the nail bed leads to significant post-operative nail deformity, Range of motion of the DIP joint in the affected finger is usually less than 10 degrees post-operatively, (OBQ09.194) 21(1): p. 31-4.

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2014 Mar;6(1):26-31. doi: 10.4055/cios.2014.6.1.26.



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