II. Precautions

  1. Proximal Phalanx Fractures are often unstable
    1. Interosseous Muscles pull the proximal Fracture into flexion
    2. Extensor Muscles pull the distal Fracture into extension

III. Signs

  1. Volar angulation of Fracture site
  2. Rotational deformity if oblique Fracture

IV. Management

  1. See Phalanx Fracture
  2. Reduction of transverse Fracture
    1. Apply traction away from tubercle of Scaphoid
    2. Flexion applied to distal fragment
  3. Immobilization for 4 weeks
    1. Splint in position of moderate flexion
  4. Open Reduction and Internal Fixation (ORIF) Indications
    1. Open Fracture
    2. Unstable Fractures
      1. Often oblique, spiral, comminuted or intraarticular
    3. Transverse Fracture with >2 mm displacement
    4. Angulation or rotation >10 degrees

V. References

  1. Perkins (2020) Crit Dec Emerg Med 34(10): 10-1

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