Phalangeal Injuries, Hand

Description

• 1/3 of all traumatic injuries affect the hand
• Phalanges account for one of the most frequently fractured parts of the skeletal system with the distal phalanx being the most commonly fractured bone in the hand
• Dorsal displacement of the proximal interphalangeal joint of the finger is the most frequent dislocation

• Disability from hand injuries can have life-changing implications based on a patient's age, vocation, and hobbies
• Injuries may be more difficult to diagnose in children who are unable to cooperate for a full exam

Etiology

• Trauma (commonly work or sports related)
• Infectious sequelae:
  • Skin flora: Staphylococcus aureus and Streptococci
  • Cat/dog bites: S. aureus and Pasteurella multocida
  • Human bites: Eikenella
  • Thorns or woody plants puncture: Fungal
  • Fresh-/salt-water exposure: Mycobacterium marinum and Pseudomonas aeruginosa
• Inflammatory (e.g., gout, RA, osteoarthritis)
• Overuse injury (e.g., “gamekeeper's thumb”)