How to treat finger joint fractures

In life, we often need to use our fingers to handle some complicated things. The flexibility of fingers also makes our work easier. However, if you accidentally break a finger, your eating, drinking and work will be affected to a certain extent. If you want your broken finger to heal faster, proper treatment is essential. So, how do hospitals generally treat finger joint fractures now?

Phalangeal fractures are most common in the hands and are mostly open fractures. Most of them are caused by direct violence and can lead to various types of fractures in any part of the fingers. Due to the different locations of phalangeal fractures, they are pulled by tendons from different directions, resulting in displacement in different directions. For example, if the middle part of the proximal phalanx is fractured, it will be pulled by the interosseous muscles and lumbrical muscles, causing an angle to the palm side; if the middle phalanx is fractured distally to the insertion point of the superficial flexor digitorum tendon, it will also cause an angle to the palm side due to its traction; if it is fractured proximal to the insertion point of the superficial flexor digitorum tendon, it will be pulled by the extensor tendon to cause an angle to the dorsal side. Intra-articular fractures of the proximal phalanx base can be divided into three categories: collateral ligament tear, compression fracture, and longitudinal split fracture. Distal phalanx fractures are mostly comminuted fractures, often without obvious displacement; while avulsion fractures of the dorsal side of the distal phalanx base usually form a hammer finger deformity.

The treatment of phalangeal fractures requires both accurate reduction and firm fixation, as well as functional exercises as early as possible to restore flexible finger movement.

For non-displaced fractures, the injured finger can be fixed with an aluminum plate or plaster in a flexed position at the metacarpophalangeal joint and slightly flexed position at the interphalangeal joint. The fixation can be removed after about 4 weeks and functional exercises can be performed. Comminuted fractures of the distal phalanx can be treated as soft tissue injuries and do not require fixation.

For displaced closed fractures, manual reduction and external fixation can be performed. The fixation position should be determined according to the displacement of the fracture. For example, if the palmar side is angulated, the finger should be fixed in a flexed position. For a dorsal avulsion fracture of the base of the distal phalanx, the proximal interphalangeal joint should be flexed and the distal interphalangeal joint should be fixed in a hyperextension position. The fixation is removed after 4 to 6 weeks.

For open fractures and closed fractures that are in poor position after reduction, open reduction and internal fixation should be performed. There are many ways to fix it, depending on the specific situation. The most commonly used method is Kirschner wire fixation, but the principle should be firm and reliable. Avulsion fractures of the phalanx base are often treated with tension band fixation. Phalangeal fractures can also be fixed with screws.