Fundamentals of Phalanx Fractures

The phalanges are small long bones that together compose the skeleton of the fingers. There are three rows for the fingers and two for the thumb, proximally the proximal phalanx articulates with the metacarpal head forming the metacarpophalangeal joint, and distally with the middle phalanx base on the proximal interphalangeal joint. The middle phalanx articulates distally with the distal phalanx on the distal interphalangeal joint, the three of them receive insertions of both the flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) on the volar side and dorsally the extensor apparatus. Therefore, the fractures of these bones, if not treated correctly can lead to deformities and disability of the hand. The fractures of the phalanges are one of the most frequent among the upper limb fractures and usually with good results when a proper surgical or nonsurgical treatment is properly applied. The main objectives of the treatment are restoring the anatomy avoiding malrotation, angulations, and shortening, making that all the digits point to a spot located near the tubercle of the scaphoid with no scissoring, reducing the possibility to cause stiffness, and returning the hand to a fully functional unit, capable of doing powerful and fine grasping, precision handling, and a combination of all the activities together when necessary.