![]() Rupture of the central slip of the extensor hood of the finger. Treatment is based on which metacarpal is involved, location of the fracture, and the rotation/angulation of the injury. Diagnosis is made by orthogonal radiographs the hand. Common finger fractures and dislocations. 15 Techniques 5 Images summary Metacarpal Fractures are the most common hand injury and are divided into fractures of the head, neck, or shaft. Splints and casts: indications and methods. Current trends in the management of proximal interphalangeal joint injuries of the hand. Fracture dislocations of the proximal interphalangeal joint. Fractures, dislocations, and thumb injuries. Evaluation and treatment of flexor tendon and pulley injuries in athletes. Avulsion of the flexor profundus tendon insertion. Single blind, prospective, randomized controlled trial comparing dorsal aluminum and custom thermoplastic splints to stack splint for acute mallet finger. Conservative versus surgical treatment of mallet finger: a pooled quantitative literature evaluation. Nonsurgical treatment of closed mallet finger fractures. Kalainov DM, Hoepfner PE, Hartigan BJ, et al. The non-operative management of bony mallet injuries. Surgical and nonsurgical management of mallet finger: a systematic review. Comparison of nail bed repair versus nail trephination for subungual hematomas in children. Phalangeal fractures: displaced/nondisplaced. Fracture-dislocation about the finger joints. The demographics of fractures and dislocations across the entire United States due to common sports and recreational activities. Volar metacarpophalangeal dislocations are rare and warrant referral. Dorsal metacarpophalangeal joint dislocations are managed with reduction and splitting, but referral to an orthopedic specialist is required if the dislocation is not easily reduced. An X-ray (Figure 1) showed an impacted fracture of the head of the metacarpal, and an MRI (Figure 2) confirmed not only the fracture but also a noncomplete oblique fracture. Distal interphalangeal joint dislocations require reduction and splinting in full extension (for volar dislocations) or 15 to 30 degrees of flexion (for dorsal dislocations) for two to three weeks. Volar proximal interphalangeal joint dislocations require reduction and splinting in full extension for four to six weeks. Dorsal proximal interphalangeal joint dislocations require reduction and buddy splinting in slight flexion with an extension-block splint. Uncomplicated middle and proximal phalanx fractures, typically caused by a direct blow, can be treated with buddy splinting if there is minimal angulation (less than 10 degrees) however, larger angulations, displacement, and malrotation often require reduction or surgery. Flexor digitorum profundus fractures are caused by forceful extension of the distal interphalangeal joint when in a flexed position, resulting in an avulsion fracture at the volar base of the distal phalanx, and usually require surgery. Uncomplicated dorsal avulsion fractures (mallet finger) of the distal interphalangeal joint, caused by forced flexion against resistance, require strict splint immobilization for eight weeks. Uncomplicated distal phalanx fractures, caused by a crush injury to the end of the finger, require splinting of the distal interphalangeal joint for four to six weeks. Anteroposterior, lateral, and oblique radiography should be performed to identify fractures and distinguish uncomplicated injuries from those requiring referral. Patients typically present with a deformity, swelling, and bruising with loss of function. For the best treatment outcome, find a physio who specialises in this area.Finger fractures and dislocations are commonly seen in the primary care setting. It’s important to note that not all physiotherapists are specialised in the area of hand therapy. providing you with a home exercises program of specific movements and strengthening exercises.soft tissue massage to help with muscle tension and pain.swelling management with massage and compression garments.Physiotherapists use a number of techniques to regain movement in your hand, wrist and fingers, including: Under your physiotherapist’s instructions, you will start moving as soon as it is safe to ensure that you don’t get too stiff. Physiotherapy is extremely important following a metacarpal fracture. If surgery is not needed, then your physiotherapist will make a custom splint, which will support the healing fracture. Your GP or physiotherapist will also look at your hand and do some gentle tests to work out if surgery is needed. This will guide what treatment is necessary. The first thing that’s needed is an X-ray to work out which bone is broken and to what extent.
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