Broken Finger (cont.)

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Medical Author:

John P. Cunha, DO, FACOEP

John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Multimedia

Media file 1:Broken finger. X-ray of a severe fracture of the proximal phalanx of the small finger. This bone is broken in many small fragments and very unstable. This injury occurred in an automobile accident, but injuries like this also can be seen in any traumatic incident. Because it was unstable, surgery was needed. In this type of injury, the surgeon may use either pins or plates and screws for repair. The pins would stay in for about 4-6 weeks, and plates and screws would be removed only if bothersome.

Media type: X-RAY

Media file 2:Broken finger. This x-ray shows an oblique (diagonal) fracture through the proximal phalanx of the ring finger. Notice how the fracture tends to slip or shorten (arrow). Not only does this fracture shorten, but rotational deformities are also seen. Usually it is not stable enough for just buddy taping, and surgery may be needed.

Media type: X-RAY

Media file 3:Broken finger. This x-ray is taken in the operating room after pinning of a fracture similar to the one in picture 2. The x-ray shows how the multiple small pins hold the fracture in anatomic alignment and the shortening is gone. This will maintain stability until the fracture is healed. The pins may be removed in 4-6 weeks.

Media type: X-RAY

Media file 4:Broken finger. A typical fracture at the end of the small finger metacarpal is shown in this x-ray. The fragment is most always flexed toward the palm as seen in this x-ray. Most typically this fracture is caused by a closed fist striking an object. This commonly is called a boxer's (or brawler's) fracture. Treatment of this fracture usually is conservative casting. Don't be alarmed by the angulation of the bone. It is usually only cosmetic, and hand function should be normal after the bone heals.

Media type: X-RAY

Media file 5:Broken finger. This x-ray illustrates a common fracture of the distal phalanx. It is an injury where the distal phalanx is forced toward the palm and resisted by the pull of the extensor tendon. This is very common in sporting events in which a ball strikes the end of the finger (often called mallet finger). These injuries are either bony (as seen) or involve ligaments. Treatment is splinting or surgical pinning of the distal phalanx. This injury may take a long time to heal and must be watched closely. Despite every effort to heal, a residual lag may continue after treatment. This usually is cosmetic only and does not affect grip strength.

Media type: X-RAY

Media file 6:Broken finger. This is an x-ray of an oblique (diagonal) fracture of a metacarpal. These injuries occur from a twisting or crush injury to the hand. They are common to machining and workplace injuries as well as direct trauma. There are many different muscles and tendons that may accentuate this fracture causing shortening or angulation toward the palm. Treatment may consist of either casting with close observation or a surgical procedure for stability of the fracture. This would depend on the severity of the fracture seen on the x-ray.