Best Practice Case Studies-Case 128 Asset 4 Phalangeal Fractures and Finger Injuries

Video Transcription

Video Summary

The lecture focused on evaluating and managing phalangeal fractures and finger injuries in athletes. The speaker reviewed finger anatomy, emphasizing the distal, middle, and proximal phalanges, and stressed the importance of a careful history, physical exam, and x-rays. Key exam points included skin and nail-bed injuries, neurovascular status, tendon function, ligament stability, and finger rotation.<br /><br />He then covered common injuries and treatment. Most distal phalanx tuft and shaft fractures are treated non-operatively with splinting, though open injuries like Seymour fractures require urgent antibiotics, irrigation, and fixation. Mallet finger injuries are usually treated with DIP extension splinting, but surgery may be needed for large intra-articular fragments or volar subluxation. Jersey finger, an FDP avulsion, is almost always surgical.<br /><br />For middle and proximal phalanx fractures, stable, minimally displaced injuries can often be managed with buddy taping and early motion. More displaced, unstable, rotated, or intra-articular fractures often require reduction and fixation. He also highlighted difficult injuries such as condylar fractures and pilon-type fracture-dislocations, which often need operative management.<br /><br />Return-to-play guidance depended on injury stability, sport, and treatment method. Protected play with taping or casting may allow early return, while long-term finger function should be balanced against short-term athletic goals.

Meta Tag

Edition 4th Edition

Related Case 4th Edition, Case 128

Topic Hand

Keywords

4th Edition

4th Edition, Case 128

Hand

phalangeal fractures

finger injuries

athletes

distal phalanx

mallet finger

jersey finger

Seymour fracture

buddy taping

return to play