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Phalangeal Fractures in the Athlete

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Sports Injuries of the Hand and Wrist

Part of the book series: In Clinical Practice ((ICP))

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Phalangeal fractures are the most frequently encountered fractures in athletes. The vast majority of phalangeal fractures are intrinsically stable and require little more than a brief period of rest, elevation and splinting. Adjusted conditioning exercises can frequently be continued with minimal discomfort.

This chapter aims to cover the clinical assessment of the suspected finger fracture and required investigations. The principles of safe splintage will be discussed as will the importance of rehabilitation and decision-making with regard to return to play. Surgical strategies for the treatment of these fractures will be described in order to help appreciate what surgery can offer but also the shortcomings. Some understanding of the surgical procedures improves communication between surgeon and sports physician and will help to design appropriate rehabilitation programmes. We dispel the myth that surgical fixation with plate and screws will automatically mean a quicker recovery and return to play.

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Questions and Answers

Questions and Answers

  • Q: What are the key aims of managing phalangeal fractures?

  • A: To prevent stiffness, maintain alignment, enable early return to function, and minimise complications.

  • Q: Which type of deformity is never acceptable?

  • A: Rotation

  • Q: What is the safe period of immobilisation of the hand?

  • A: Less than 3 weeks

  • Q: What is the intrinsic plus position?

  • A: Wrist extension 30°, MCPJ flexion 70–90°, IPJs extended

  • Q: What anatomical structure causes the characteristic apex volar deformity of a proximal phalanx fracture?

  • A: The central slip of the extensor tendon

  • Q: What proportion of patients achieve full ROM after open reduction and internal fixation of phalangeal fractures?

  • A: 10%

  • Q: When can an athlete with a phalangeal fracture return to play?

  • A: This depends on fracture pattern, treatment, symptoms, sport, position, the athlete and time of the season.

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Logan, J., Warwick, D. (2019). Phalangeal Fractures in the Athlete. In: Hayton, M., Ng, C., Funk, L., Watts, A., Walton, M. (eds) Sports Injuries of the Hand and Wrist. In Clinical Practice. Springer, Cham.

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-02133-7

  • Online ISBN: 978-3-030-02134-4

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