The bones of the fingers, known as the phalanges, play a crucial role in hand function. Each finger (except the thumb) contains three phalanges—the proximal, middle, and distal—which work together with muscles, tendons, and joints to provide dexterity and strength.
The phalanges form hinge-like joints, allowing precise movements such as gripping, pinching, typing, and manipulating small objects. With only two phalanges, the thumb works in opposition to the fingers, greatly enhancing the hand’s functional capacity.
When any of these phalanges are broken—a condition known as a phalanx fracture—it disrupts the alignment and stability of the finger. A fracture may involve a crack, a complete break, or even multiple fragments of bone.
Some common causes of phalanx fractures include:
- Falls onto an outstretched hand—commonly occurring during sports, slips, or trips.
- Direct blows to the hand—from sports (e.g., baseball, basketball), accidents, or striking objects.
- Crush injuries, such as getting a finger caught in a door or machinery.
- Twisting injuries—involving torsional force, often seen in contact sports or physical altercations.
- Industrial or occupational accidents that occur when handling heavy equipment or tools.
- Motor vehicle collisions—resulting in impact or crush injuries to the hand.
Symptoms of Phalanx Fractures
Recognizing the symptoms of a phalanx fracture right away is vital. Getting a diagnosis promptly can prevent complications such as poor bone healing, finger stiffness, and long-term dysfunction.
The most common symptoms of phalanx fractures to watch for include:
- Pain and tenderness at the site of the injury
- Swelling and bruising of the finger
- Deformity—the finger may appear crooked or out of alignment
- Inability or difficulty moving the finger
- Numbness or tingling—if nerves are involved
- Open wounds or bleeding (if the fracture is associated with a laceration)
Treatment Options for Phalanx Fractures
For a suspected phalanx fracture, initial non-surgical treatments typically include immobilizing the finger with a splint or buddy taping it to an adjacent finger to provide stability and reduce pain. Icing, elevating the hand, and taking over-the-counter pain medications can also help reduce swelling and discomfort.
Surgical Treatments
Surgery for a phalanx fracture is generally recommended when the fracture is severely displaced, involves multiple fragments, or when the joint surface is affected. Other indications include open fractures (with an associated wound), fractures that fail to heal properly, or fractures related to nerve or tendon injury.
The most common surgical procedures for phalanx fractures include:
- Open reduction and internal fixation (ORIF): repositioning bone fragments and securing them with pins, screws, or plates.
- Percutaneous pinning: using pins inserted through the skin to stabilize the fracture.
- External fixation: In more complex cases, a device outside the body stabilizes the fracture.
After surgery, patients can expect a period of immobilization, often followed by physical therapy to restore motion, strength, and function. Full recovery times vary but typically range from several weeks to months.
