Overview
what it is and why it mattersPhalangeal fractures are extremely common and range from a stable non-displaced proximal phalanx fracture to a complex intra-articular pilon fracture of the middle or distal phalanx requiring surgical reconstruction. The most important factors in management are: rotation (always a surgical indication), articular involvement, and which phalanx is injured — proximal phalanx fractures are most likely to cause permanent stiffness if not managed carefully.
Diagnosis
exam first, imaging secondPA, lateral, and oblique finger X-rays. Rotational deformity is assessed clinically. CT is added for complex intra-articular injuries. Tendon integrity (FDP for mallet/jersey-finger, central slip for boutonnière) must be assessed clinically.
Treatment Path
how care progresses at OSI1
Buddy taping
For non-displaced stable fractures — the adjacent finger acts as a dynamic splint.
2
Dorsal extension blocking splint
For volar plate avulsion fractures — blocks full extension while allowing flexion.
Surgical Options at OSI
if non-operative care isn't enoughRotation, intra-articular step-off >1 mm at the PIP or DIP joint, and fractures unstable in splinting require fixation.
Providers Who Treat Phalangeal Fracture
sports-medicine team
Further Reading
authoritative sourcesExternal patient-education references and related OSI pages for additional background: