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A fracture of the fingers (digits) or thumb refers to a disruption, or break, in any of their associated bones. The bones of the fingers are called phalanges (plural) or phalanx (singular). Each finger has three small bones. They are referred to as distal, middle, and proximal, depending on their position along the length of the finger. The bones are connected at joints (the knuckles) that allow the fingers to flex. The thumb, being shorter, has only two bones and two joints.
Any phalanges can be fractured by a direct blow, rotation, twisting, and by crushing injuries. Dislocations and/or open wounds may accompany the fractures. Fractures of the end of the finger (distal phalanx) may include an injury to the nail bed, which means the fracture must be treated as an open fracture. When the fingers are injured, soft tissue structures can get between the fragments, making realignment of the bones into their anatomically normal position (reduction) difficult and tendon or ligament damage likely.
Finger fractures are described by the fracture name and location (e.g., nondisplaced spiral fracture of the proximal phalanx). The fragments may protrude through the skin (open or compound fracture) or may cause deformity of the finger without tearing the skin (closed fracture). Function of the hand is maintained when the fingers and thumb are able to move in correct relation to each other and to the wrist bones. A fracture to any of these small bones has the potential to change this relationship, which can be painful and debilitating. Tendon rupture is a significant injury that often accompanies finger fractures.
Risk: The risk of finger and thumb fractures increases with participating in contact sports (e.g., hockey, football), or skiing, particularly in children and adolescents. Bone or joint disease (e.g., osteoporosis), and poor nutrition (e.g., calcium deficiency) are also risk factors. Postmenopausal women and both men and women of advancing age are at increased risk of finger and thumb fractures as a result of accidental falls. Incidence and Prevalence: Phalangeal fracture incidence is often difficult to determine because of under-reporting, but these fractures are estimated to comprise approximately 10% of all fractures (Divelbiss). A Canadian study of hand fractures found that phalangeal fractures comprised half of the 72,000 hand fractures studied. Annual incidence for hand fracture was estimated to range from 29 per 10,000 for individuals aged 20 or older to 61 per 10,000 for individuals younger than 20 years (Feehan, 2006). Fractures of the distal phalanx are the most common fractures of the hand and frequently result from industrial accidents (Lyn). |