#EMconf: Finger injuries

  • Phalynx dislocations are grouped into the direction of the dislocated fragment: Dorsal vs Volar
    -Dorsal dislocations: most common type , associated with volar plate injuries at PIP joint 
    -Volar dislocations: associated with central slip injury of extensor tendon at PIP joint, unable to fully extend finger 
    -Refer to specialist if unable to fully extend finger, associated fracture fragment > 30-40% of articular surface, difficult reduction 
    -Splint finger in full extension if suspect central slip injury 


  • The following phalynx fractures need to be referred to a hand specialist: 

Sources: -First Aid for the EM Boards, 3rd edition, Blok et. al
              -Tintinalli's Emergency Medicine A Comprehensive Study Guide, 8th edition, Tintinalli et. al.