MANUAL MINORS
Fractures of the middle and proximal phalanges of the fingers are common injuries resulting from direct or indirect trauma to the hand, such as falls, blows, or crush injuries. These fractures can be simple or complex, displaced or non-displaced, and significantly affect finger function by impairing mobility and alignment.
Diagnosis
Diagnosis is made through clinical evaluation of the trauma, presenting with pain, swelling, deformity, and limited movement in the affected finger. X-rays of the fingers are used to confirm the location, type of fracture (transverse, oblique, spiral), and the degree of displacement.
Differential Diagnosis
Condition | Main Characteristics |
|---|---|
Interphalangeal dislocation | Joint displacement without visible bone fracture on X-rays. |
Fracture-dislocation | Fracture combined with a dislocation at the interphalangeal or metacarpophalangeal joint. |
Finger sprain | Ligament injury without fracture, with pain and limited movement. |
Emergency Management
Initial management includes immobilising the affected finger with a splint or bandage to stabilise the fracture and prevent further displacement. Pain and inflammation are controlled with analgesics or anti-inflammatory medications. In cases of significant displacement or instability, a closed reduction under local anaesthesia may be required.
Definitive Treatment
Non-displaced fractures: Continuous immobilisation with digital splints for 3 to 6 weeks, depending on the fracture type, is usually sufficient.
Displaced or unstable fractures: Open reduction and internal fixation using pins, screws, or plates may be required to restore proper bone alignment.
Rehabilitation with physical therapy is essential to restore finger function and mobility after immobilisation or surgery.
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