Avulsion fracture involving <30% articular base of the middle phalanx: Tenuous: Avulsion fracture involving 30%-50% articular base of the middle phalanx; reduces with <30° of flexion: Unstable: Avulsion fracture involving <50% articular base of the middle phalanx but requires >30° flexion to maintain reduction : PIPJ indicates proximal interphalangeal joint.

Phalanx fractures typically occur by crush injury, hyperextension, or direct axial force (eg, stubbing the toe). 2. Weeks 0 to 3 or 4 1.
Supplemental casting or splinting to ensure adequate reduction 5,7. Throbbing pain is characteristic, and dependent position may worsen the pain. K-wire pin tract care as ordered by the physician. In certain cases, when close reduction is still possible, percutaneous screw insertion may be tried. The distal phalanx fractures are commonly either comminuted or transverse and better treated with K-wires. Author information: (1)Okayama University Medical School and Okayama Saiseikai General Hospital, Japan. For fractures of the middle phalanx, if conservative treatment is not sufficient, then percutaneous pinning or open reduction using K-wires is used. Radiographic features These fractures are generally well visualized on plain radiographs. The intra-articular fracture of the phalangeal basis with a displaced dorsal fragment can, however, be fixed by two or three mini-screws after open reduction. The importance of anatomical restoration of the volar lip of the middle phalanx for normal PIP joint stability has been demonstrated. Middle phalanx fracture treated with K-wire stabilization to attain reduction A. 6 Fractures of the hand 6.14 II Fractures of the middle phalanx — Nonoperative treatment %1 Foundation litoerland ocio conomic ommitee 6 andWoo`—Nonoperative Fracture reatment Hource ur\er eference ll.aosur\ern.or\ 3 of 3 5 Aftertreatment 5.1 Follow up X-ray checks of fracture … The wire should end in the subchondral bone of the middle phalanx. At that point, fracture reduction and pin placement are confirmed with fluoroscopy. Weeks 2 to 4: AROM begins according to physician recommendation. C. Weeks 3 to 6 1. Attention should now be turned to the nail bed laceration. Classification, management and long-term results. The K-wire can either be cut beneath the level of the skin for later removal in the operating room (OR) or the wire can be left outside the skin, bent 90°, and cut. Phalanx fractures: The most common foot fractures. B. Comment in J Bone Joint Surg Br. 5.

3 Patients with phalanx fractures typically present with pain at or near the site of injury, edema, ecchymosis, and erythema. Ultrasonography can be used in unclear cases. Seno N(1), Hashizume H, Inoue H, Imatani J, Morito Y. 1998 May;80(3):555-6. Middle phalanx fractures are the least common of the phalanx fractures.
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