Executive Editor: Chris Colton

Authors: Renato Fricker, Matej Kastelec, Fiesky Nuñez, Terry Axelrod

Thumb - Proximal phalanx: Base and shaft - multifragmentary

General considerations

Comminuted fractures are rarely isolated injuries, as they usually result from high-energy trauma (crushing). Soft-tissue lesions are frequently associated with the potential risk of edema, fibrotic reactions and eventual stiffness.
For these reasons, these injuries are usually treated by ORIF, in order to provide sufficient stability for immediate mobilization, reducing the risk of joint stiffness and tendon adhesions.

Depending on the forces acting on the bone, two kinds of comminuted fractures are common: small fragment comminution, or wedge fractures.

The degree and type of comminution depends on the forces and energy that acted on the thumb. In some cases, a large wedge fragment may result from the injury. In such cases, vascularity has not usually been significantly compromised.

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v1.0 2008-11-08