Executive Editor: Chris Colton

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

Proximal phalanx - Shaft, oblique

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Glossary

General considerations

Fractures of the distal metaphysis can be transverse, oblique, or comminuted.

Stable undisplaced fractures can be treated nonoperatively. Any displacement or instability will usually require ORIF.
Other indications for ORIF are open fractures, or soft-tissue lacerations. In these cases, ORIF is the best option.

Nonoperative treatment
Main indication Skill Equipment
Minimally displaced and/or stable Basic surgical experience, no specialized skills Basic equipment only

Contraindications

  • Open fractures
  • Rotationally unstable fractures
Compression plate fixation
Main indication Skill Equipment
Open fracture or gross displacement Highly experienced and skilled surgeon Simple surgical and imaging resources

Contraindications

  • Poor soft tissues
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

v1.0 2008-11-08