Distal phalanx fracture
| Distal phalanx fracture | |
|---|---|
| Other names: Fingertip fracture, tuft fracture, fracture of the distal phalanx | |
 | |
| X-rays of a tuft fracture, lateral (left) and AP (right) | |
 | |
| Specialty | Plastic surgery |
| Symptoms | Painful and swollen finger tip, bleeding under the nail[1][2] |
| Complications | Nail bed laceration, nail deformity, bone infection[2][1] |
| Causes | Crush injury[3] |
| Diagnostic method | X-ray[1] |
| Differential diagnosis | Mallet finger, Seymour fracture[4] |
| Treatment | Buddy tapping, splinting, K-wire[3][1][5] |
| Prognosis | May take 6 months to fully improve[6] |
| Frequency | Common[1] |
Distal phalanx fractures, which include tuft fractures, are breaks of the bone at the tip of the finger.[7] Symptoms include a painful and swollen finger tip.[2] It maybe associated with a bleeding under the nail or nail bed laceration.[1] Complications may include nail deformity, or bone infection.[2][1]
The cause is generally a crush injury.[3] It is a type of finger fracture.[8] Diagnosis is by X-ray.[1] Types include transverse, longitudinal, and comminuted.[4] Mallet fingers and Seymour fractures require specific measures.[4]
Cases in which the skin is intact can generally be treated with buddy tapping or splinting for a few weeks.[3][1] Bleeding under the nail may be treated with making a hole in the nail.[1][5] If the bones are displaced, reduction may be required.[2] If more than 30% of the joint is involved, the fracture is unstable, or the fracture is open further measures may be required.[2] In open fractures, preventative antibiotics are generally not required.[2][1]
Distal phalanx fracture are common, being the most common hand fracture.[1][2] Males are more commonly affected than females.[9] Numbness and sensitivity, including to cold, commonly persists for months.[6]
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 "Fingertip Fractures - Injuries; Poisoning". Merck Manuals Professional Edition. Archived from the original on 23 March 2023. Retrieved 24 February 2024.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 Wang, QC; Johnson, BA (15 May 2001). "Fingertip injuries". American family physician. 63 (10): 1961–6. PMID 11388710.
- ↑ 3.0 3.1 3.2 3.3 "Hand and finger fractures". www.clinicalguidelines.scot.nhs.uk. NHSGGC Paediatrics for Health Professionals. Archived from the original on 26 September 2023. Retrieved 23 February 2024.
- ↑ 4.0 4.1 4.2 "Distal Phalanx Fracture". fpnotebook.com. Archived from the original on 5 February 2023. Retrieved 24 February 2024.
- ↑ 5.0 5.1 Chen, F; Kalainov, DM (March 2017). "Phalanx fractures and dislocations in athletes". Current reviews in musculoskeletal medicine. 10 (1): 10–16. doi:10.1007/s12178-017-9378-7. PMID 28185123.
- ↑ 6.0 6.1 Oetgen, ME; Dodds, SD (June 2008). "Non-operative treatment of common finger injuries". Current reviews in musculoskeletal medicine. 1 (2): 97–102. doi:10.1007/s12178-007-9014-z. PMID 19468880.
- ↑ "Tuft fractures". Cambridge University Hospitals. Archived from the original on 6 June 2023. Retrieved 24 February 2024.
- ↑ McDaniel, Dalton J.; Rehman, Uzma H. (November 2, 2021). "Phalanx Fractures of the Hand". StatPearls. StatPearls Publishing. PMID 32491557. Archived from the original on December 29, 2020. Retrieved October 28, 2023 – via PubMed.
- ↑ "UpToDate". www.uptodate.com. Archived from the original on 25 February 2024. Retrieved 24 February 2024.