Fractures of the Proximal Phalanx and Those Involving the Metacarpo-Phalangeal Joint

  • David J. ShewringEmail author


Fractures of the proximal phalanx are amongst the most common affecting the hand. In a large study by Stanton et al. [1], the proximal phalanx accounted for 17 % of 691 hand fractures studied. Although many of these fractures can be treated non-operatively [2], they can be unforgiving, particularly those affecting the phalangeal shaft [3].


Fracture Phalanx Avulsion Condyle K-wire Lag screw Nonunion Malunion Osteotomy Internal fixation 


  1. 1.
    Stanton JS, Dias JJ, Burke FD. Fractures of the tubular bones of the hand. J Hand Surg Eur. 2007;32(6):626–36.CrossRefGoogle Scholar
  2. 2.
    Barton N. Internal fixation of hand fractures. J Hand Surg. 1989;14B(2):139–42.CrossRefGoogle Scholar
  3. 3.
    Horton TC, Hatton M, Davis TRC. A prospective randomized controlled study of fixation of long oblique and spiral shaft fractures of the proximal phalanx: closed reduction and percutaneous Kirschner wiring versus open reduction and lag screw fixation. J Hand Surg Eur. 2003;28(1):5–9.CrossRefGoogle Scholar
  4. 4.
    James JI. Fractures of the proximal and middle phalanges of the fingers. Acta Orthop Scand. 1962;32:401–12.PubMedCrossRefGoogle Scholar
  5. 5.
    Belsky MR, Eaton RG, Lane LB. Closed reduction and internal fixation of proximal phalangeal fractures. J Hand Surg. 1984;9A:725–9.CrossRefGoogle Scholar
  6. 6.
    Green DP, Anderson JR. Closed reduction and percutaneous pin fixation of fractured phalanges. J Bone Joint Surg. 1973;55A:1651–3.Google Scholar
  7. 7.
    Hornbach EE, Cohen MS. Closed reduction and percutaneous pinning of fractures of the proximal phalanx. J Hand Surg. 2001;26B(1):45–9.CrossRefGoogle Scholar
  8. 8.
    Ford DJ, El-Hadidi S, Lunn PG, Burke FD. Fractures of the phalanges: results of internal fixation using 1.5 mm and 2 mm A.O. screws. J Hand Surg. 1987;12B(1):28–33.CrossRefGoogle Scholar
  9. 9.
    Shewring DJ, Thomas RH. Avulsion fractures from the base of the proximal phalanges of the fingers. J Hand Surg Eur. 2003;28(1):10–4.CrossRefGoogle Scholar
  10. 10.
    Lister GD. Intra-osseous wiring of the digital skeleton. J Hand Surg. 1978;3:427–35.CrossRefGoogle Scholar
  11. 11.
    Dixon GL, Moon NF. Roational supracondylar fractures of the proximal phalanx in children. Clin Orthop Relat Res. 1972;188:120–30.Google Scholar
  12. 12.
    Newington DP, Craigen MA, Bennet GC. Children’s proximal phalangeal neck fractures with 180 rotation deformity. J Hand Surg. 1995;20B(3):353–6.CrossRefGoogle Scholar
  13. 13.
    Hastings 2nd H, Carroll CT. Treatment of closed articular fractures of the metacarpophalangeal and proximal interphalangeal joints. Hand Clin. 1988;4:503–27.PubMedGoogle Scholar
  14. 14.
    Sammut D, Evans D. The bone tie: a new device for interfragmentary fixation. J Hand Surg. 1999;24B(1):64–9.CrossRefGoogle Scholar
  15. 15.
    Day CS, Stern PJ. Chapter 8. Fractures of the metacarpals and phalanges. In: Wolfe SW, Hotchkiss RN, Pederson WC, Kozin SH, editors. Green’s operative hand surgery, vol. 1. 6th ed. Philadelphia: Elsevier/Churchill Livingstone; 2011. p. 239–90.CrossRefGoogle Scholar
  16. 16.
    Teoh LC, Yong FC, Chong KC. Advancement osteotomy for correcting condylar malunion of the finger. J Hand Surg. 2002;26B(1):31–5.CrossRefGoogle Scholar
  17. 17.
    Smith FL, Ryder DL. A study of the healing of one hundred consecutive phalangeal fractures. J Bone Joint Surg. 1935;17A:91–109.Google Scholar
  18. 18.
    Jupiter JB, Koniuch MP, Smith RJ. The management of delayed union and nonunion of the metacarpals and phalanges. J Hand Surg. 1985;10A:457–66.CrossRefGoogle Scholar
  19. 19.
    Buchler U, Gupta A, Ruf S. Corrective osteotomy for post traumatic malunion of the phalanges in the hand. J Hand Surg. 1996;21B(1):33–42.CrossRefGoogle Scholar
  20. 20.
    Menon J. Correction of rotary malunion of the fingers by metacarpal rotational osteotomy. Orthopaedics. 1990;13:197–200.Google Scholar
  21. 21.
    Shewring DJ, Thomas RH. Collateral ligament avulsion fractures from the heads of the metacarpals of the fingers. J Hand Surg Eur. 2006;31(5):537–41.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  1. 1.Department of Trauma and OrthopaedicsUniversity Hospital of WalesCardiffUK

Personalised recommendations