Review Question - QID 306

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Phalanx Dislocations QID: 306 (OBQ06.120)

QID 306 (Type "306" in App Search)

A collegiate baseball player injures his left small finger sliding into third base. He complains of pain and swelling. The finger is ecchymotic, swollen throughout, and painful with attempted range of motion of the PIP joint. No sensory or vascular deficits are present. A radiograph is provided in Figure A. Which of the following interventions will provide the best outcome?

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Buddy taping the small finger to the ring finger

77/3927

Immobilization of the MCP in flexion and the PIP and DIP in extension with a custom splint

111/3927

External fixation

63/3927

Open reduction internal fixation

93%

3650/3927

PIP joint arthrodesis

3/3927

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The radiograph shows an oblique fracture of the distal proximal phalanx that extends into the joint with an articular step off. Open reduction internal fixation will correct the deformity, expedite finger rehabilitation, and prevent early degenerative arthritis. Closed treatment without fixation will not reliably hold the fracture reduced while the bone heals. Arthrodesis is unnecessary in this young, active patient.

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