WHAT IS A PHALANX FRACTURE?
The phalanx bones (called phalanges in plural) are the long slender bones which form your fingers. There are three phalanges in each of the fingers, and only two phalanges in the thumb. Between each phalanx is a joint or finger “knuckle” that allow the fingers to move. Fractures are “breaks” or “cracks” in the bone, usually due to trauma. In severe injuries, multiple phalanges can be fractured. Mallet fractures are a common type of phalanx fracture that occurs due to jamming injuries at the end of the finger.
CAUSES
Most causes of phalanx fracture involve trauma to the fingers:
· Sudden “jamming” injuries to the fingers (mallet fractures)
· Twisting or hyperextension injuries (dog leashes, falls, sports)
· Blunt force trauma (work injuries, sports, vehicle accidents)
· Hand crush injuries
· Enchondroma (benign bone cyst that weakens the bone until it fractures)
SIGNS AND SYMPTOMS
Symptoms of a phalanx fracture usually include one or more of the following:
· Finger pain and tenderness
· Finger swelling / stiffness
· Finger bruising
· Finger deformity (crooked fingers, end of finger won’t straighten)
IS THERE A TEST FOR PHALANX FRACTURES?
Yes! Often fractures are obvious on physical examination, but severe sprains and contusions can also look and feel very much like a phalanx fracture. X-rays usually offer definitive diagnosis and help with treatment planning.
TREATMENT
Suspected hand fractures warrant emergent treatment if you are experiencing hand numbness and tingling, severe or “tight” swelling, significant deformity of the hand or any open wounds around the hand (possible open or compound fracture). Even without these warning signs, it is best to seek urgent treatment as the results of delayed treatment of phalanx fractures can lead to undesirable outcomes such as nonunion (won’t heal) or malunion (heals crooked).
Nonoperative Treatment:
Splinting and buddy taping are the mainstays of nonoperative treatment for phalanx fractures. For many fractures, we start some early gentle motion, sometimes with Hand Therapy, to prevent permanent stiffness, but always follow the direction of your surgeon when it comes to moving or stretching a broken finger.
Operative Treatment:
Surgical repair of phalanx fractures is required when the fracture pieces are unstable (won’t stay in place), or not healing properly with splint treatment. Mild sedation is given, and a local block numbing of the finger is performed in the operating room. If the phalanx can be set straight, metal wires are placed through the skin and into the bone to keep it straight while it is healing. If the fracture is severe, it may be necessary to make a small incision over the finger to restore the alignment of the broken phalanx directly and hold the pieces in place with tiny metal plate and/or screws. Often, a second surgery is performed after the bone has healed, in order to remove the plate and screws if they are bothersome under the skin or causing finger stiffness.
READY TO CONFIRM A DIAGNOSIS AND FIX THE PROBLEM OR JUST WANT TO LEARN MORE?
I am here to help! I can often diagnose the problem in one visit, and get you started with a treatment plan. I offer a wide variety of both nonoperative and operative treatment options.
Call Hand Institute of Charleston today for a clinic or telehealth appointment! 854-423-4263
This article is not a substitute for in-person medical advice or diagnosis and is for educational purposes only.
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