Fractures of fingers: causes, symptoms, diagnosis, treatment

ICD-10 code

• 562.5. Fracture of the thumb of the hand.
• 562.6. Fracture of the other finger of the hand.
• 562.7. Multiple fractures of fingers.

Epidemiology of fracture of fingers

Fractures of fingers of a brush meet quite often and reach 5% of all damages of bones.

[1], [2], [3], [4], [5]

What causes a fracture of the fingers of the hand?

In most cases, finger fractures are the result of a direct mechanism of injury, mainly domestic and industrial nature. Under the influence of deep and superficial flexors of the fingers, as well as vermiform and interosseous muscles, with fractures of the phalanges of the fingers, a typical displacement of the fragments occurs at an angle open in the rear.

Symptoms of a finger fracture

There are all signs of damage to short tubular bones: deformation due to displacement of fragments, edema and bruising. Painful on palpation. Pathological mobility and crepitation of fragments. Violation of the functions of the finger and hand.

Diagnosis of finger fracture of the hand

The X-ray in two projections specifies the nature of the fracture.

[6], [7], [8], [9]

Treatment of finger fracture

Indications for hospitalization

By its structure and functionality, the brush is an extremely complex organ, so any damage to it requires an individual approach, thoughtful, rational treatment at all stages. Fractures of the phalanx of the fingers are referred to the section of severe brush injuries. In outpatient settings, treatment of fractures without displacement of fragments and single fractures of phalanges is permissible, which after repositioning do not give secondary displacements.

The success of treatment of fractures of finger phalanges depends on careful anatomical comparison of fragments, complete immobilization in terms of volume and timing, and subsequent complex therapy.

Conservative treatment of finger fracture of the hand

In the fracture region, 3-5 ml of a 2% solution of procaine is administered. After waiting 5-7 minutes, proceed to reposition: traction along the axis, then the finger is bent in all joints to a functionally advantageous position (angle 120 °) and by pressure from the palmar side eliminate the angular deformation. The limb is fixed with palmar gypsum langet from the upper third of the forearm to the heads of metacarpal bones, and then only the injured finger is immobilized. Extension in the wrist joint is 30 °, the phalanx of the fingers is bent until it comes into contact with the opposed first finger, which is approximately 60 °. This position achieves the following objectives:

• relaxation of flexor tendons and vermiform muscles - prevention of secondary displacement;
• optimal tension of ring-shaped ligaments - prevention of contractures;
• with complications in the form of persistent contractures or ankylosis in the joints of the fingers, the grasping function of the hand remains.

Immobilization of intact fingers is considered a surgical error. In the same way, the injured finger can not be fixed in the extended position.

The first day after the injury, the cold and the elevated limb position are prescribed to prevent edema of the tissues and reduce pain. Inward or parenterally, metamizole sodium is indicated. On the 3rd day, UHF is assigned to the fracture site and therapeutic gymnastics for the non-immobilized fingers and elbow joint. Gypsum is removed after 3-4 weeks, X-ray control is performed and restorative treatment is started: warm baths (soda, salt) with LFK in water, ozocerite applications, LFK for interphalangeal joints, forearm massage, mechanotherapy.

The ability to work is restored in 4-6 weeks.

The treatment period is shorter in the case of fracture of terminal phalanges without displacement of fragments and fracture of sesamoid bones of the hand: immobilization for 2-3 weeks, work capacity is restored in 3-4 weeks.

With multiple fractures, the phalanges of the fingers perform a closed manual reposition and fix the injured fingers with a gypsum longus for 3-4 weeks. Labor - in 6-8 weeks.

The method of skeletal traction is used in cases where it is impossible to retain fragments. The limb is fixed with a plaster dressing, the same as after repositioning, but with a wire hook crocheted on the palmar surface. Anesthetize the nail phalanx 2-3 ml of a 2% solution of procaine and conduct a device for traction. It can be a silk thread, carried through soft tissues or a nail plate, a special pin, thin spokes or staples embedded in the bone of the terminal phalanx. It is good to stretch the nail plates, which are coated with a layer of polymer resin (AKR-100, steracryl, etc.) with a built-in loop for stretching. The stretch lasts 3 weeks and for another 1-3 weeks the limb is fixed with a gypsum removable lunget. Labor - in 4-6 weeks.

Surgical treatment of finger fracture

Surgical treatment consists in an open reposition and (most often) intraosseous fixation by Kirschner's knitting needles. Hard fixation of fragments is achieved with the help of miniature compression-distraction apparatuses. Terms of immobilization: permanent and removable - for 2-3 weeks. Labor - in 6-8 weeks.

With multiple fractures, recovery of disability occurs in 6-8 weeks or more.