Pediatric Phalanx Fracture in the Hand

  • Etiology: Trauma
  • Imaging Radiograph:
    — Volar plate fractures of the fingers are relatively common football injuries
    — Dislocated fingers are often associated with fractures
    — Dislocations of metacarpal phalyngeal joints of hand are uncommon but severe injuries
  • Note: Finger fractures can be difficult to identify without proper history of where child hurts
  • DDX:
  • Complications: Intraarticular phalangeal condylar fractures can result in osteonecrosis, osteoarthritis, or stiff joints
  • Treatment: Fractures of the distal phalanx that involve the nailbed should be considered open fractures due to the insertion of the nail matrix and posterior ligament on the bone
  • Clinical:

Radiology Cases of Phalanx Fracture in the Hand

Radiology Cases of Phalanx Fracture Dislocation in the Hand

Radiograph of fracture dislocation of the fifth phalanx of the hand
AP (left), oblique (middle) and lateral (right) radiographs of the fifth digit show a complete dislocation of the fifth middle phalanx from the fifth proximal phalanx.

Radiology Cases of Salter Harris Type III Phalanx Fracture in the Hand

Radiograph of Salter Harris Type III phalanx fracture
Lateral radiograph of the hand shows a fracture line through the physis and extending into the epiphysis of the fourth middle phalanx. There is a fracture fragment displaced dorsally.

Radiology Cases of Salter Harris Type IV Phalanx Fracture in the Hand

Radiograph of Salter-Harris Type IV fracture of the proximal aspect of the middle phalanx
AP radiograph of the hand shows a linear lucency in the fourth middle phalanx extending from the metaphysis through the physis and into the epiphysis. There is associated cortical irregularity along the medial aspect of the metaphsis.