Proximal phalanx (finger) fracture - Revision history

Rossdonaldson1: /* Clinical Features */

2023-03-22T22:42:43Z

Clinical Features

← Older revision		Revision as of 22:42, 22 March 2023
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	==Clinical Features==		==Clinical Features==
	*~~Finger pain~~		*Pain and/or swelling of the digit

	==Differential Diagnosis==		==Differential Diagnosis==

Rossdonaldson1 at 22:39, 22 March 2023

2023-03-22T22:39:32Z

← Older revision		Revision as of 22:39, 22 March 2023
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	*The flexor digitorum superficialis (FDS) inserts at the middle of the phalanx and can cause rotational deformity<ref name="Hand and wrist emergencies">German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>		*The flexor digitorum superficialis (FDS) inserts at the middle of the phalanx and can cause rotational deformity<ref name="Hand and wrist emergencies">German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>
	*Extensor tendons and interosseous muscles commonly causes volar angulation<ref name="Hand and wrist emergencies">German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>		*Extensor tendons and interosseous muscles commonly causes volar angulation<ref name="Hand and wrist emergencies">German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>

			{{Finger fracture types}}

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: /* Management */

2019-09-18T02:57:27Z

Management

← Older revision		Revision as of 02:57, 18 September 2019
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	==Management==		==Management==
	*If requires ortho referral: [[Radial gutter splint]] or [[ulnar gutter splint]]<ref name="Hand and wrist emergencies">German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management ~~for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>~~		{{General Fracture Management}}

	===Nondisplaced, stable===		===Nondisplaced, stable===
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	*Consider closed reduction		*Consider closed reduction
	**After reduction ensure that PIP joint is in extension, MCP is in flexion (to avoid contracture)		**After reduction ensure that PIP joint is in extension, MCP is in flexion (to avoid contracture)

			===Immobilization===
			*If requires ortho referral: [[Radial gutter splint]] or [[ulnar gutter splint]]<ref name="Hand and wrist emergencies">German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>

	==Disposition==		==Disposition==

Rossdonaldson1: /* Management */

2016-10-16T11:47:28Z

Management

← Older revision		Revision as of 11:47, 16 October 2016
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	==Management==		==Management==
	*If requires ortho referral: [[Radial gutter splint]] or [[ulnar gutter splint]]<ref name="Hand and wrist emergencies">German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>		*If requires ortho referral: [[Radial gutter splint]] or [[ulnar gutter splint]]<ref name="Hand and wrist emergencies">German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>
	*Nondisplaced, stable: Consider [[buddy taping]] the injured finger to an adjacent finger
			===Nondisplaced, stable===
			*Consider [[buddy taping]] the injured finger to an adjacent finger
	**If the ring finger is involved it should be [[buddy taped]] to the little finger		**If the ring finger is involved it should be [[buddy taped]] to the little finger
	**Dorsal or volar [[Finger Splint]] if desire added protection		**Dorsal or volar [[Finger Splint]] if desire added protection
	*Displaced or angulated fracture
	**Consider closed reduction		===Displaced or angulated fracture===
	***After reduction ensure that PIP joint is in extension, MCP is in flexion (to avoid contracture)		*Consider closed reduction
			**After reduction ensure that PIP joint is in extension, MCP is in flexion (to avoid contracture)

	==Disposition==		==Disposition==

Rossdonaldson1 at 11:36, 16 October 2016

2016-10-16T11:36:45Z

← Older revision		Revision as of 11:36, 16 October 2016
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	==Background==		==Background==
	*The flexor digitorum superficialis (FDS) inserts at the middle of the phalanx and can cause rotational deformity		*The flexor digitorum superficialis (FDS) inserts at the middle of the phalanx and can cause rotational deformity<ref name="Hand and wrist emergencies">German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>
	*Extensor tendons and interosseous muscles commonly causes volar angulation		*Extensor tendons and interosseous muscles commonly causes volar angulation<ref name="Hand and wrist emergencies">German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>

	==~~Workup~~==		==Clinical Features==
			*Finger pain

			==Differential Diagnosis==
			{{Hand and finger fractures DDX}}

			==Evaluation==
			===Physical===
	*Examine the phalanx with the fingers in full extension and flexion		*Examine the phalanx with the fingers in full extension and flexion
	*Assess for malrotation		*Assess for malrotation

	==Imaging==		===Imaging===
	*AP, lateral, oblique		*AP, lateral, oblique
	**Examine for rotation, shortening, angulation		**Examine for rotation, shortening, angulation

	~~==Differential Diagnosis==~~
	~~{{Hand and finger fractures DDX}}~~

	==Management==		==Management==
	*If requires ortho referral: [[Radial gutter splint]] or [[ulnar gutter splint]]		*If requires ortho referral: [[Radial gutter splint]] or [[ulnar gutter splint]]<ref name="Hand and wrist emergencies">German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>
	*Nondisplaced, stable: Consider [[buddy taping]] the injured finger to an adjacent finger		*Nondisplaced, stable: Consider [[buddy taping]] the injured finger to an adjacent finger
	**If the ring finger is involved it should be [[buddy taped]] to the little finger		**If the ring finger is involved it should be [[buddy taped]] to the little finger
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	==References==		==References==
	<references/>		<references/>
	*UpToDate
	*German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.


	[[Category:Orthopedics]]		[[Category:Orthopedics]]

Ted Fan: background

2016-10-11T16:17:50Z

background

← Older revision		Revision as of 16:17, 11 October 2016
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	==Background==		==Background==
			*The flexor digitorum superficialis (FDS) inserts at the middle of the phalanx and can cause rotational deformity
			*Extensor tendons and interosseous muscles commonly causes volar angulation

	==Workup==		==Workup==
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	==Management==		==Management==
	*If requires ortho referral: Radial or [[ulnar gutter splint]]		*If requires ortho referral: [[Radial gutter splint]] or [[ulnar gutter splint]]
	*Nondisplaced, stable: Consider [[buddy taping]] the injured finger to an adjacent finger		*Nondisplaced, stable: Consider [[buddy taping]] the injured finger to an adjacent finger
	**If the ring finger is involved it should be [[buddy taped]] to the little finger		**If the ring finger is involved it should be [[buddy taped]] to the little finger
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	==References==		==References==
	<references/>		<references/>
	UpToDate		*UpToDate
			*German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.


	[[Category:Orthopedics]]		[[Category:Orthopedics]]

Neil.m.young: Text replacement - "==Treatment==" to "==Management=="

2016-07-08T04:14:24Z

Text replacement - "==Treatment==" to "==Management=="

← Older revision		Revision as of 04:14, 8 July 2016
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	{{Hand and finger fractures DDX}}		{{Hand and finger fractures DDX}}

	==~~Treatment~~==		==Management==
	*If requires ortho referral: Radial or [[ulnar gutter splint]]		*If requires ortho referral: Radial or [[ulnar gutter splint]]
	*Nondisplaced, stable: Consider [[buddy taping]] the injured finger to an adjacent finger		*Nondisplaced, stable: Consider [[buddy taping]] the injured finger to an adjacent finger

Rossdonaldson1: Text replacement - "fx" to "fracture"

2016-07-08T03:23:45Z

Text replacement - "fx" to "fracture"

← Older revision		Revision as of 03:23, 8 July 2016
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	**If the ring finger is involved it should be [[buddy taped]] to the little finger		**If the ring finger is involved it should be [[buddy taped]] to the little finger
	**Dorsal or volar [[Finger Splint]] if desire added protection		**Dorsal or volar [[Finger Splint]] if desire added protection
	*Displaced or angulated fx		*Displaced or angulated fracture
	**Consider closed reduction		**Consider closed reduction
	***After reduction ensure that PIP joint is in extension, MCP is in flexion (to avoid contracture)		***After reduction ensure that PIP joint is in extension, MCP is in flexion (to avoid contracture)
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	**Intraarticular		**Intraarticular
	**Unstable		**Unstable
	***Spiral or oblique fx		***Spiral or oblique fracture
	***Condylar fx		***Condylar fracture
	***Neck fx		***Neck fracture
	***Large avulsion fx		***Large avulsion fracture
	**Rotated		**Rotated
	***NO degree of rotation is acceptable following a reduction		***NO degree of rotation is acceptable following a reduction

Neil.m.young: Text replacement - "* " to "*"

2016-07-08T02:45:18Z

Text replacement - "* " to "*"

← Older revision		Revision as of 02:45, 8 July 2016
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	==Workup==		==Workup==
	* Examine the phalanx with the fingers in full extension and flexion		*Examine the phalanx with the fingers in full extension and flexion
	* Assess for malrotation		*Assess for malrotation

	==Imaging==		==Imaging==
	* AP, lateral, oblique		*AP, lateral, oblique
	** Examine for rotation, shortening, angulation		**Examine for rotation, shortening, angulation

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Treatment==		==Treatment==
	* If requires ortho referral: Radial or [[ulnar gutter splint]]		*If requires ortho referral: Radial or [[ulnar gutter splint]]
	* Nondisplaced, stable: Consider [[buddy taping]] the injured finger to an adjacent finger		*Nondisplaced, stable: Consider [[buddy taping]] the injured finger to an adjacent finger
	** If the ring finger is involved it should be [[buddy taped]] to the little finger		**If the ring finger is involved it should be [[buddy taped]] to the little finger
	** Dorsal or volar [[Finger Splint]] if desire added protection		**Dorsal or volar [[Finger Splint]] if desire added protection
	* Displaced or angulated fx		*Displaced or angulated fx
	** Consider closed reduction		**Consider closed reduction
	*** After reduction ensure that PIP joint is in extension, MCP is in flexion (to avoid contracture)		***After reduction ensure that PIP joint is in extension, MCP is in flexion (to avoid contracture)

	==Disposition==		==Disposition==
	* Refer for:		*Refer for:
	** Intraarticular		**Intraarticular
	** Unstable		**Unstable
	*** Spiral or oblique fx		***Spiral or oblique fx
	*** Condylar fx		***Condylar fx
	*** Neck fx		***Neck fx
	*** Large avulsion fx		***Large avulsion fx
	** Rotated		**Rotated
	*** NO degree of rotation is acceptable following a reduction		***NO degree of rotation is acceptable following a reduction
	** Shortened		**Shortened
	** Significantly angulated		**Significantly angulated
	*** Less than 10 degrees may be tolerated		***Less than 10 degrees may be tolerated

	==See Also==		==See Also==

Neil.m.young: Text replacement - "==Source==" to "==References== "

2016-06-26T22:33:07Z

Text replacement - "==Source==" to "==References== <references/>"

← Older revision		Revision as of 22:33, 26 June 2016
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	*[[Hand Diagnoses (Main)]]		*[[Hand Diagnoses (Main)]]

	==~~Source~~==		==References==
			<references/>
	UpToDate		UpToDate

	[[Category:Orthopedics]]		[[Category:Orthopedics]]