Which medical history is characteristic of middle finger phalangeal fractures?

Updated: Jan 18, 2018
  • Author: Jay E Bowen, DO; Chief Editor: Craig C Young, MD  more...
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Answer

Middle phalangeal fractures

  • The mechanism of injury of middle phalangeal fractures is usually the result of a blunt or crush force perpendicular to the long axis of the bone. Angulation and rotation are 2 features of instability that must be examined.

  • Visual inspection usually detects dislocations and subluxations but is most valuable in the angulatory or rotary deformities that can accompany subluxation/dislocations. These deformities suggest complications ranging from asymmetric ligament tears to interposed tissues between joint surfaces. Rotational deformities are serious injuries and are detected clinically. Patients should be asked to fully flex the phalanges, and the long axis of the fingers should point to the scaphoid tubercle or the distal radius with the fingers parallel to each other.

  • Dorsal or volar angulation is evaluated radiographically in relation to the insertion of the flexor digitorum superficialis. Fractures distal to the tendon result in volar angulation, and proximal fractures result in dorsal angulation from the resulting muscle pull.


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