- Phalangeal Injury
Location Pattern Skeleton Deformity Soft Tissue Injury Motion
Base Transverse Simple Angulation Closed Skin Stable
Shaft Oblique Impacted Dorsal Open Tendon Unstable
Neck Spiral Comminuted Palmar Ligament
Condyle Avulsion Bone loss Rotation Nerve
Epiphysis Shortening Blood Vessel
- Acceptable Alignment: (phalangeal & metacarpal frx)
- 10 deg angulation in both sagittal and coronal planes except in
metaphysis, where 20 deg angulation in sagittal plane is accepted;
- up to 45 deg angulation in sagittal plane in neck of 5th metacarpal;
- 50% overlap at the fracture;
- no rotation deformity;
- frx that is markedly displaced before reduction did not necessarily
require internal fixation after adequate reduction;
- Stable Frx:
- include closed impacted shaft frx;
- frx w/ little or no displacement;
- most distal phalangeal frxs;
- many isolated metacarpal shaft frxs;
- Unstable Fractures:
- rotated Spiral Fractures
- comminuted fractures
- severely displaced fractures
- some short Oblique Fractures
- multiple fractures
- subcondylar proximal phalanx fractures
- palmar base middle phalanx fractures
- fractures with associated extensive soft tissue injury
- displaced articular fractures: Bennett's and reversed Bennett's
Location Pattern Skeleton Deformity Soft Tissue Injury Motion
Base Transverse Simple Angulation Closed Skin Stable
Shaft Oblique Impacted Dorsal Open Tendon Unstable
Neck Spiral Comminuted Palmar Ligament
Condyle Avulsion Bone loss Rotation Nerve
Epiphysis Shortening Blood Vessel
- Acceptable Alignment: (phalangeal & metacarpal frx)
- 10 deg angulation in both sagittal and coronal planes except in
metaphysis, where 20 deg angulation in sagittal plane is accepted;
- up to 45 deg angulation in sagittal plane in neck of 5th metacarpal;
- 50% overlap at the fracture;
- no rotation deformity;
- frx that is markedly displaced before reduction did not necessarily
require internal fixation after adequate reduction;
- Stable Frx:
- include closed impacted shaft frx;
- frx w/ little or no displacement;
- most distal phalangeal frxs;
- many isolated metacarpal shaft frxs;
- Unstable Fractures:
- rotated Spiral Fractures
- comminuted fractures
- severely displaced fractures
- some short Oblique Fractures
- multiple fractures
- subcondylar proximal phalanx fractures
- palmar base middle phalanx fractures
- fractures with associated extensive soft tissue injury
- displaced articular fractures: Bennett's and reversed Bennett's