What are Some Different Types of Bone Fractures?

Fractures of the phalanges are most common in the hand, and most are open fractures. And most are caused by direct violence, which can cause various types of fractures at any part of the finger. Due to the different parts of the phalanx, it is pulled by tendons from different directions, resulting in different directions of displacement. For example, the middle phalanx fractures are pulled by the interosseous and vermiform muscles, which leads to the angle of the palm. ; The middle segment of the phalanx fractures at the distal of the superficial flexor tendon, due to its traction, also makes an angle to the palm; if the proximal digit of the digital flexor tendon is fractured, the extensor tendon will cause an angle to the back . Intra-articular fractures of the proximal base of the phalanx can be divided into three types: collateral ligament tear, compression fracture, and longitudinal split fracture. The distal phalanx fractures are mostly comminuted fractures, often without obvious displacement; and the avulsion fractures on the dorsal side of the base of the distal phalanx usually form hammer-shaped finger deformities.

Basic Information

nickname

Fracture of bamboo

English name

fracture of fingers phalanges

Visiting department

orthopedics

Multiple groups

adult

Common locations

hand

Common causes

Direct violence

Common symptoms

Pain, swelling, limited mobility, local deformity

Causes of phalanx fractures

Mostly caused by direct violence.

Clinical manifestations of phalangeal fractures

The position of the phalanx is superficial. In addition to the obvious pain, swelling, tenderness and limited mobility after the injury, obvious deformities are visible. For patients with suspicious fractures, a radiograph can confirm the diagnosis. The treatment of phalangeal fractures often fails to attract great attention, often caused by malalignment or non-union due to poor alignment or improper fixation, and often caused by contracture of the joint capsule and lateral collateral ligament due to improper fixation or prolonged fixation. Joint stiffness; especially fractures near or through the joints, often leading to joint stiffness and severely affecting finger function.

Phalanx fracture examination

X-ray examination can show the fracture and type.

Phalanx fracture diagnosis

Diagnosis can be made based on medical history, clinical manifestations and X-ray examination.

Fracture of phalanges

Ankylosis of the knuckles is often complicated.

Treatment of phalanx fractures

In the treatment of phalanx fractures, both accurate reduction and firm fixation must be achieved, and functional exercises must be performed as early as possible to restore the flexible movement function of the fingers.

For fractures without displacement, the injured finger can be fixed to the metacarpophalangeal joint flexion and interphalangeal joint microflexion with aluminum plate or plaster, and removed and fixed for about 4 weeks for functional training. The comminuted fracture of the distal phalanx can be treated as a soft tissue injury and does not need to be fixed.

Closed fractures with displacement may be reduced by external fixation. The fixed position should be determined according to the displacement of the fracture. For example, the palmar angled person fixes the finger in the flexed position; Joint hyperextension is fixed. Removed and fixed 4 to 6 weeks.

For open fractures and closed fractures with poor position after reduction, open reduction and internal fixation should be performed. There are many ways to fix it. Depending on the specific situation, the commonly used method is still Kirschner wire fixation, but it should be based on the principle of firmness and reliability. Avulsion fractures of the base of the phalanx are usually treated with tension bands. Fracture of the phalanx can also be fixed with screws.