Distal phalanx (finger) fracture

Clinical Presentation

Examination

• Evaluate for tendon damage

Imaging

• Comminuted tuft fx
  • Stable
• Longitudinal fx
  • Usually non-displaced and stable
• Transverse fx
  • Evaluate for angulation/displacement
• Intraarticular fx

Differential Diagnosis

Distal Finger (Including Nail) Injury

• Distal interphalangeal dislocation (finger)
• Distal phalanx (finger) fracture
• Finger amputation
• Fingertip avulsion
• Finger infection
• Nailbed laceration
• Nail avulsion
• Subungual hematoma

Treatment

• Nondisplaced: Splint with the DIP joint in extension (splint should extend past the tip of the distal phalanx
  • Do not attempt to reduce comminuted tuft fx

Disposition

• Refer for:
  • Tendon dysfunction
  • Nerve dysfunction
  • Displacement or angulation
  • Intraarticular fx

See Also

• Finger (Phalanx) Fracture
• Hand Diagnoses (Main)

Source

UpToDate