Fracture of the phalanx of the finger
Content:
- Causes of fractures of the phalanges of the fingers
- Symptoms of a phalanx fracture
- Diagnostics
- Treatment of a fracture of the phalanx of the fingers
- How to develop a toe after a fracture?
Each finger consists of three tubular bones, or phalanges: the nail, middle and main, with the exception of the thumb, which has two of them. A fracture of a finger should not be mistaken for a minor injury, since without adequate treatment it can have certain negative consequences: limitations in flexion of the finger, pain even with light loads, and a decrease in grip strength.
Fractures of the digital phalanges are a fairly common injury, the frequency of which is about 5% of all recorded fractures. The nail phalanx of the index finger is most often damaged; in 29% of cases, multiple fractures are observed.
Causes of fractures of the phalanges of the fingers
Usually, a fracture occurs as a result of a direct injury (domestic, industrial, sports), a fall of a heavy object on the hand or a bruise, in more rare cases, due to excessive extension or twisting of the fingers.
Symptoms of a phalanx fracture
The main signs of a fracture include:
- The aching pain that extends to the entire finger can be given to the hand, arm to the elbow and intensifies when touched and palpated;
- Swelling at the site of the fracture;
- Subcutaneous hemorrhage and hematoma formation;
- Restriction of movement - a characteristic feature is the impossibility of fully extending the broken finger, which is well detected when placing the palms on the table: the injured finger will not adhere to the table surface;
- Finger deformity.
A finger fracture can be associated with joint dislocation, tendon or ligament damage. Injuries to 2-5 fingers do not differ much from each other. A broken thumb can be easily confused with a bruise or dislocation. Most often, its main phalanx is damaged.
With a fracture with displacement, in addition to pain and hemorrhage, there is a noticeable deformation (lengthening or shortening of the finger), pathological mobility, the inability to make active movements, for example, to clench the hand into a fist. Any of these signs indicate a fracture. Diagnosis of a fracture without displacement presents significant difficulties; X-ray is required to confirm it.
Diagnostics
If there are signs of a fracture, an X-ray of the finger is taken in two projections to determine the location of the fracture and its type. A phalanx fracture can be transverse, spiral or comminuted, in the latter case crepitus is noted (crunch of fragments on palpation).
The diagnosis of fractures without displacement, cracks and intra-articular fractures is of considerable difficulty.
Treatment of a fracture of the phalanx of the fingers
If there is no displacement and the joint is not affected, conservative treatment is applied. The damaged fragment of the finger is fixed with a plaster cast or a polymer bandage. An adjacent finger can be used as a splint.
If there is displacement but the fracture is not considered unstable, it can be repaired without surgery under local anesthesia. After that, the palay is fixed in the same way. A phalanx fracture usually heals in 3-4 weeks. During this time, control X-rays are taken to ensure that the bones are properly fused.
If the fracture is unstable, the articular surfaces are affected, the fragments are displaced and there is severe deformation, a surgical operation (osteosynthesis) is necessary to restore the correct anatomy of the hand. To do this, open reduction of bone fragments is performed: an incision is made to gain access to the fracture site, the fragments are compared and fixed using metal structures - pins, plates, screws. The wound is sutured and closed with a sterile bandage, and the sutures are removed after two weeks. The advantages of this method include the guaranteed restoration of the anatomy of the finger, the possibility of its early development; to the cons - a small residual scar.
If the victim does not agree to the operation, then titanium needles are inserted through the skin. The advantages of this method include the simplicity and speed of the procedure, the absence of an incision and subsequent scar. The disadvantages are the likelihood of infection of the fracture area, since the end of the spoke remains outside, prolonged wearing of plaster (up to 1 month), the impossibility of early development of the finger, which can result in irreversible contracture (limited passive movements in the joint).
On the subject: 12 traditional home remedies
How to develop a toe after a fracture?
The performance of the hand will depend on the full restoration of the functions of the fingers. The rehabilitation program is drawn up together with the attending physician. You need to start developing fingers immediately after removing the plaster. Additionally, physiotherapy and massage are prescribed. You can also perform these exercises with intact fingers of both hands from 2-3 days after the injury.
- Put your hands on the table with palms, tear your fingers off the table surface alternately and together;
- While in the same position, pinch and spread your fingers;
- Make circular movements with the pads of your fingers on the table surface, clockwise and counterclockwise;
- Raise your hands and in the air, consistently bring your fingers together and apart, gradually increasing the pace;
- Collect your fingers in a "pinch" and relax; can be done on the table and in the air;
- Take out the tip of the thumb with each finger, folding them in the form of a ring;
- Bend 2-5 fingers alternately, while the 1st finger is pulled to the side;
- Clench your fingers into a fist, and then sharply straighten them. This exercise is very effective when done in warm water (about 38 ° C).
Also useful:
- Pour 2 different cereals on the table, mix them, and then sort;
- To sort out the rosary;
- Collect a children's designer;
- Work at the keyboard;
- Use a wrist expander;
- Just stretch your fingers with your good hand.
All exercises are recommended to be performed 10-15 times, 3-4 approaches per day. It is good to do them in warm water, after dissolving sea salt in it. After charging, you can rub in an anti-inflammatory ointment.
Author of the article: Kaplan Alexander Sergeevich | Orthopedist
Education: diploma in the specialty "General Medicine" received in 2009 at the Medical Academy. I. M. Sechenov. In 2012 completed postgraduate studies in Traumatology and Orthopedics at the City Clinical Hospital named after Botkin at the Department of Traumatology, Orthopedics and Disaster Surgery.
