Executive Editor: Chris Colton

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

Middle phalanx - Proximal, dorsal avulsion fracture

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Glossary

General considerations

Dorsal avulsion fractures of the middle phalanx are very common injuries, often resulting from sporting injuries and usually involving the middle and ring fingers. The soft tissue component of this injury is the most important factor determining stability of the joint. Usually the joints are stable and can be managed nonoperatively. With larger fragments and collateral ligament injury the joint will become unstable and require surgical treatment.

Dorsal lag screw fixation
Main indication Skill Equipment
Significantly displaced fragment, and/or joint subluxation, open fractures Some specialized surgical experience Simple surgical and imaging resources

Contraindications

  • Grossly contaminated wound
Tension-band wiring
Main indication Skill Equipment
Significantly displaced fragment, and/or joint subluxation, open fractures Some specialized surgical experience Simple surgical and imaging resources

Contraindications

  • Grossly contaminated wound
*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