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Phalanx fractures and dislocations in athletes

  • Hand and Wrist Sports Medicine (E Tolo and L Dwyer, section editors)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

Purpose of review

Phalangeal fractures, dislocations, and fracture-dislocations in the hand are common injuries. We review the current literature on the diagnosis and treatment of these injuries in the athlete. An understanding of the anatomy and its relationship to the mechanism of injury may help to direct appropriate management. Return to play remains an important concern to the patient-athlete.

Recent findings

Findings from recently published articles reinforce previously established treatment methods in the management of finger phalangeal fractures, dislocations, and fracture-dislocations. The majority of these injuries can be treated non-operatively. Technological advances in implant designs may conceivably allow for earlier rehabilitation and, in turn, a more expeditious return to sport. Management of phalangeal injuries in the elite athlete often necessitates special treatment considerations.

Summary

The majority of phalangeal bone and joint injuries in the athlete can be treated in a comparable manner to the non-athlete. The goals of treatment are restoration of bone and joint alignment and stability in order to hasten a return to competition. Surgery as a means to expedite return to play in the high-level athlete should be determined on a case by case basis. Technological improvements in surgical implants may enable accelerated postoperative recovery. However, to our knowledge, there are no published studies to definitively support this assumption.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Immerman I, Livermore MS, Szabo RM. Use of emergency department services for hand, wrist, and forearm fractures in the US in 2008. J Surg Orthop Adv. 2014;23:98–104. doi:10.3113/JSOA.2014.0098.

    Article  PubMed  Google Scholar 

  2. Chung KC, Spilson SV. The frequency and epidemiology of hand and forearm fractures in the United States. J Hand Surg [Am]. 2001;26:908–15. doi:10.1053/jhsu.2001.26322.

    Article  CAS  Google Scholar 

  3. Court-Brown CM, Wood AM, Aitken S. The epidemiology of acute sports-related fractures in adults. Injury. 2008;39:1365–72. doi:10.1016/j.injury.2008.02.004.

    Article  PubMed  Google Scholar 

  4. Rettig AC. Epidemiology of hand and wrist injuries in sports. Clin Sports Med. 1998;17:401–6.

    Article  CAS  PubMed  Google Scholar 

  5. Aitken S, Court-Brown AM. The epidemiology of sports-related fractures of the hand. Injury. 2008;39:1377–83. doi:10.1016/j.injury.2008.04.012.

    Article  PubMed  Google Scholar 

  6. Shaftel ND, Capo JT. Fractures of the digits and metacarpals: when to splint and when to repair? Sports Med Arthrosc. 2014;22:2–11. doi:10.1097/JSA.0000000000000004.

    Article  PubMed  Google Scholar 

  7. • Kodama N, Takemura Y, Ueba H, Imai S, Matsusue Y. Operative treatment of metacarpal and phalangeal fractures in athletes: early return to play. J Orthop Sci. 2014;19:729–36. doi:10.1007/s00776-014-0584-5. Retrospective study of hand fractures in athletes following a protocol of surgery and early rehabilitation to return high-level athletes to sports participation.

    Article  PubMed  Google Scholar 

  8. Mall NA, Carlisle JC, Matava MJ, Powell JW, Goldfarb CA. Upper extremity injuries in the National Football League: part I: hand and digital injuries. Am J Sports Med. 2008;36:1938–44. doi:10.1177/0363546508318197.

    Article  PubMed  Google Scholar 

  9. Gaston RG, Chadderdon C. Phalangeal fractures: displaced/nondisplaced. Hand Clin. 2012;28:395–401. doi:10.1016/j.hcl.2012.05.032.

    Article  PubMed  Google Scholar 

  10. • Meals C, Meals R. Hand fractures: a review of current treatment strategies. J Hand Surg [Am]. 2013;38:1021–31. doi:10.1016/j.jhsa.2013.02.017. A comprehensive review of the treatment options for management of hand fractures.

    Article  Google Scholar 

  11. • Cotterall IH, Richard MJ. Metacarpal and phalangeal fractures in athletes. Clin Sports Med. 2015;34:69–98. doi:10.1016/j.csm.2014.09.009. A review of important concepts and considerations in the treatment of phalangeal fractures in the athlete.

    Article  Google Scholar 

  12. Capo JT, Hastings 2nd H. Metacarpal and phalangeal fractures in athletes. Clin Sports Med. 1998;17:491–511.

    Article  CAS  PubMed  Google Scholar 

  13. Roser SE, Gellman H. Comparison of nail bed repair and trephination for subungual hematomas in children. J Hand Surg [Am]. 1999;24:1166–70.

    Article  CAS  Google Scholar 

  14. Hsu LP, Schwartz EG, Kalainov DM, Chen F, Makowiec RL. Complications of K-wire fixation in procedures involving the hand and wrist. J Hand Surg [Am]. 2011;36:610–16. doi:10.1016/jhsa.2011.01.023.

    Article  Google Scholar 

  15. Geissler WB. Operative fixation of metacarpal and phalangeal fractures in athletes. Hand Clin. 2009;25:409–21. doi:10.1016/j.hcl.2009.05.005.

    Article  PubMed  Google Scholar 

  16. Gajendran VK, Szabo RM, Myo GK, Curtiss SB. Biomechanical comparison of double-row locking plates versus single- and double-row non-locking plates in a comminuted metacarpal fracture model. J Hand Surg [Am]. 2009;34:1851–58. doi:10.1016/j.jhsa.2009.07.005.

    Article  Google Scholar 

  17. Yaffe MA, Saucedo JM, Kalainov DM. Non-locked and locked plating technology for hand fractures. J Hand Surg [Am]. 2011;36:2052–55. doi:10.1016/j.jhsa.2011.09.023.

    Article  Google Scholar 

  18. Singletary S, Freeland AE, Jarrette CA. Metacarpal fractures in athletes: treatment, rehabilitation, and safe early return to play. J Hand Ther. 2003;16:171–79.

    Article  PubMed  Google Scholar 

  19. London PS. Sprains and fractures involving the interphalangeal joints. Hand. 1971;3:155–58.

    Article  CAS  PubMed  Google Scholar 

  20. Weiss AP, Hastings 2nd H. Distal unicondylar fractures of the proximal phalanx. J Hand Surg [Am]. 1993;18:594–99.

    Article  CAS  Google Scholar 

  21. Tan JSW, Foo ATL, Chew WCY, Teoh LC. Articularly placed interfragmentary screw fixation of difficult condylar fractures of the hand. J Hand Surg [Am]. 2011;36:604–9. doi:10.1016/j.jhsa.2011.09.023.

    Article  Google Scholar 

  22. Bindra RR, Foster BJ. Management of proximal interphalangeal joint dislocations in athletes. Hand Clin. 2009;25:423–35. doi:10.1016/j.hcl.2009.05.008.

    Article  PubMed  Google Scholar 

  23. Redler I, William JT. Rupture of a collateral ligament of the PIP of the finger: analysis of 18 cases. J Bone Joint Surg Am. 1967;49:322–26.

    Article  CAS  PubMed  Google Scholar 

  24. McCue FC, Honner R, Johnson MC, Gieck JH. Athletic Injuries of the proximal interphalangeal joint requiring surgical treatment. J Bone Joint Surg Am. 1970;52:937–56.

    Article  CAS  PubMed  Google Scholar 

  25. Isani A, Melone Jr CP. Ligamentous injuries of the hand in athletes. Clin Sports Med. 1986;5:757–72.

    CAS  PubMed  Google Scholar 

  26. Abouzahr KM, Poblete JV. Irreducible dorsal dislocation of the distal interphalangeal joint: case report and literature review. J Trauma. 1997;42:743–45.

    Article  CAS  PubMed  Google Scholar 

  27. Chung S, Sood A, Lee E. Principles of management of isolated dorsal distal interphalangeal joint dislocations. Eplasty. 2014;14:ic33.

    PubMed  PubMed Central  Google Scholar 

  28. Leddy JP, Packer JW. Avulsion of the profundus tendon insertion in athletes. J Hand Surg [Am]. 1977;2:66–9.

    Article  CAS  Google Scholar 

  29. Kang GCW, Yam A, Phoon ES, Lee JYL, Teoh LC. The hook plate technique for fixation of phalangeal avulsion fractures. J Bone Joint Surg Am. 2012;94:e72. doi:10.2106/JBJS.K.00601.

    Article  PubMed  Google Scholar 

  30. Husain SN, Dietz SF, Kalainov DM, Lautenschlager EP. A biomechanical study of distal interphalangeal joint subluxation after mallet fracture injury. J Hand Surg [Am]. 2008;33:26–30. doi:10.1016/j.jhsa.2007.09.006.

    Article  Google Scholar 

  31. Kalainov DM, Hoepfner PE, Hartigan BJ, Carroll IV C, Genuario J. Nonsurgical treatment of closed mallet finger fractures. J Hand Surg [Am]. 2005;30:580–86.

    Article  Google Scholar 

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Correspondence to Franklin Chen.

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Conflict of interest

Franklin Chen reports royalties from Acumed, Inomed, and Biomet, outside of the submitted work.

David M. Kalainov reports product design consulting personal fees from Acumed and Skeletal Kinetics, as well as product design discussion with OsteoMed, outside of the submitted work.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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There has been no financial support or sponsorship agreement for this work.

Additional information

This article is part of the Topical Collection on Hand and Wrist Sports Medicine

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Chen, F., Kalainov, D.M. Phalanx fractures and dislocations in athletes. Curr Rev Musculoskelet Med 10, 10–16 (2017). https://doi.org/10.1007/s12178-017-9378-7

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