The Orthobullets Podcast

Foundations | Hand | Phalanx Fractures

6 snips
Oct 8, 2025
Discover the fascinating world of phalanx fractures! The podcast delves deep into their diagnosis and treatment, highlighting which digits are most affected. Learn about phalanx anatomy and how displacement occurs due to muscle influences. Get insight into effective clinical evaluations, imaging techniques, and the nuances of treating proximal and middle phalanx fractures. Plus, explore the intricacies of managing distal phalanx injuries and the structures causing deformities, making this a must-listen for MSK professionals!
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INSIGHT

Epidemiology And Diagnostic Basics

  • Phalanx fractures commonly affect the distal phalanx and the small finger most often.
  • Diagnosis requires orthogonal radiographs and treatment ranges from immobilization to surgery based on alignment.
INSIGHT

Anatomy Drives Deformity Patterns

  • Distal phalanx has tuft, shaft, and base while middle/proximal have head, neck, shaft, and base.
  • Tendon attachments (FDP, FDS, central slip, terminal extensor) determine typical fracture displacement.
ADVICE

Essential History, Exam, And Imaging

  • Always document hand dominance, baseline function, occupation, mechanism, and neurovascular status.
  • Obtain PA, lateral, and oblique radiographs and assess for rotational deformity with tenodesis.
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