Distal phalanx fracture

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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)
SpecialtyPlastic surgery
SymptomsPainful and swollen finger tip, bleeding under the nail[1][2]
ComplicationsNail bed laceration, nail deformity, bone infection[2][1]
CausesCrush injury[3]
Diagnostic methodX-ray[1]
Differential diagnosisMallet finger, Seymour fracture[4]
TreatmentBuddy tapping, splinting, K-wire[3][1][5]
PrognosisMay take 6 months to fully improve[6]

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]


  1. 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. 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. 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. 4.0 4.1 4.2 "Distal Phalanx Fracture". fpnotebook.com. Archived from the original on 5 February 2023. Retrieved 24 February 2024.
  5. 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. 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.
  7. "Tuft fractures". Cambridge University Hospitals. Archived from the original on 6 June 2023. Retrieved 24 February 2024.
  8. 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.
  9. "UpToDate". www.uptodate.com. Archived from the original on 25 February 2024. Retrieved 24 February 2024.