Phalangeal fracture

A phalangeal fracture is a broken finger bone — one of the most common fractures we see. The pattern can range from a clean crack in a single bone to a shattered finger-joint surface (a pilon-type fracture). Three things drive how we treat it: whether the finger is rotated (twisted out of line — that always needs surgery), whether the break runs into a joint surface, and which finger bone broke. The bone closest to the palm (the proximal phalanx) is the one that most often leaves the finger stiff if it isn't managed carefully.

Three X-ray views of the finger — front, side, and angled. Rotation is checked in the office: when you make a loose fist, all your finger tips should point at the same spot in your wrist. If the broken finger swings off line, that's a rotational deformity that needs to be fixed. A CT scan adds detail when the break runs through a joint. Your provider also tests the tendons that bend and straighten the finger — a fracture can damage those at the same time.

Surgery is needed when the finger is rotated out of line, when the break has left a step in a joint surface (more than about 1 mm), or when the fracture won't stay aligned in a splint. The repair uses small pins, screws, or plates to hold the bone in place while it heals.

External patient-education references and related OSI pages for additional background:

• Britannica — Bone disease (fractures)
• Britannica — Hand (anatomy)
• AAOS OrthoInfo — patient education library
• OSI glossary — orthopedic terminology in plain language