Transverse and Short Oblique Phalangeal Fractures
Transverse phalangeal fractures result from direct blows to the digits or severe flexion-extension forces. Not infrequently, there is an open wound and an accompanying tendon injury. Transverse phalangeal shaft fractures may be completely displaced and accompanied by severe swelling, and closed reduction becomes difficult if not impossible. This situation is an indication for open reduction and internal fixation. Angulation is volar and may be quite deceptive and, therefore, easy to underestimate as the transverse fracture approaches the metacarpophalangeal joint. It is extremely important in such injuries to obtain a true lateral x-ray of the digit and to measure the actual angulation.
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