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Finger Fracture and Dislocation
Carol L. Andrews, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Diagnostic Checklist

        TERMINOLOGY

        • Definitions

          • Boutonnière deformity: Extensor tendon central slip injury at or near insertion on middle phalanx; results in proximal interphalangeal (PIP) joint flexion + distal interphalangeal (DIP) extension
          • Coach's finger: PIP dislocation, typically dorsal; ± volar plate injury
          • Jersey (rugby) finger: Flexor digitorum profundus (FDP) tendon avulsion ± avulsion fracture
            • Most commonly affects ring finger
          • Gamekeeper's (skier's) thumb: Injury to ulnar collateral ligament (UCL) of 1st metacarpophalangeal (MCP) joint
            • Related to hyperabduction
            • ± avulsion fracture
          • Mallet (baseball, drop) finger: Forced flexion of extended DIP joint with injury to terminal extensor tendon ± avulsion fracture

        IMAGING

        • General Features

          • Radiographic Findings

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    PATHOLOGY

                    • Staging, Grading, & Classification

                      • Mechanisms of Injury

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Consider

                                  • Image Interpretation Pearls

                                    • Reporting Tips

                                      Selected References

                                      1. Freilich AM: Evaluation and treatment of jersey finger and pulley injuries in athletes. Clin Sports Med. 34(1):151-66, 2015
                                      2. Prucz RB et al: Finger joint injuries. Clin Sports Med. 34(1):99-116, 2015
                                      3. Jones NF et al: Common fractures and dislocations of the hand. Plast Reconstr Surg. 130(5):722e-736e, 2012
                                      4. Williams CS 4th: Proximal interphalangeal joint fracture dislocations: stable and unstable. Hand Clin. 28(3):409-16, xi, 2012
                                      5. Lisle DA et al: MR imaging of traumatic and overuse injuries of the wrist and hand in athletes. Magn Reson Imaging Clin N Am. 17(4):639-54, vi, 2009
                                      6. Kijowski R et al: The role of ultrasound in the evaluation of sports medicine injuries of the upper extremity. Clin Sports Med. 25(3):569-90, viii, 2006
                                      7. Papadonikolakis A et al: Fractures of the phalanges and interphalangeal joints in children. Hand Clin. 22(1):11-8, 2006
                                      8. Rettig AC: Athletic injuries of the wrist and hand: part II: overuse injuries of the wrist and traumatic injuries to the hand. Am J Sports Med. 32(1):262-73, 2004
                                      9. Rosner JL et al: Imaging of athletic wrist and hand injuries. Semin Musculoskelet Radiol. 8(1):57-79, 2004
                                      10. Clavero JA et al: MR imaging of ligament and tendon injuries of the fingers. Radiographics. 22(2):237-56, 2002
                                      11. Rajesh A et al: Hand fractures: a study of their site and type in childhood. Clin Radiol. 56(8):667-9, 2001
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Diagnostic Checklist

                                            TERMINOLOGY

                                            • Definitions

                                              • Boutonnière deformity: Extensor tendon central slip injury at or near insertion on middle phalanx; results in proximal interphalangeal (PIP) joint flexion + distal interphalangeal (DIP) extension
                                              • Coach's finger: PIP dislocation, typically dorsal; ± volar plate injury
                                              • Jersey (rugby) finger: Flexor digitorum profundus (FDP) tendon avulsion ± avulsion fracture
                                                • Most commonly affects ring finger
                                              • Gamekeeper's (skier's) thumb: Injury to ulnar collateral ligament (UCL) of 1st metacarpophalangeal (MCP) joint
                                                • Related to hyperabduction
                                                • ± avulsion fracture
                                              • Mallet (baseball, drop) finger: Forced flexion of extended DIP joint with injury to terminal extensor tendon ± avulsion fracture

                                            IMAGING

                                            • General Features

                                              • Radiographic Findings

                                                • CT Findings

                                                  • MR Findings

                                                    • Ultrasonographic Findings

                                                      • Imaging Recommendations

                                                        PATHOLOGY

                                                        • Staging, Grading, & Classification

                                                          • Mechanisms of Injury

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Demographics

                                                                • Natural History & Prognosis

                                                                  • Treatment

                                                                    DIAGNOSTIC CHECKLIST

                                                                    • Consider

                                                                      • Image Interpretation Pearls

                                                                        • Reporting Tips

                                                                          Selected References

                                                                          1. Freilich AM: Evaluation and treatment of jersey finger and pulley injuries in athletes. Clin Sports Med. 34(1):151-66, 2015
                                                                          2. Prucz RB et al: Finger joint injuries. Clin Sports Med. 34(1):99-116, 2015
                                                                          3. Jones NF et al: Common fractures and dislocations of the hand. Plast Reconstr Surg. 130(5):722e-736e, 2012
                                                                          4. Williams CS 4th: Proximal interphalangeal joint fracture dislocations: stable and unstable. Hand Clin. 28(3):409-16, xi, 2012
                                                                          5. Lisle DA et al: MR imaging of traumatic and overuse injuries of the wrist and hand in athletes. Magn Reson Imaging Clin N Am. 17(4):639-54, vi, 2009
                                                                          6. Kijowski R et al: The role of ultrasound in the evaluation of sports medicine injuries of the upper extremity. Clin Sports Med. 25(3):569-90, viii, 2006
                                                                          7. Papadonikolakis A et al: Fractures of the phalanges and interphalangeal joints in children. Hand Clin. 22(1):11-8, 2006
                                                                          8. Rettig AC: Athletic injuries of the wrist and hand: part II: overuse injuries of the wrist and traumatic injuries to the hand. Am J Sports Med. 32(1):262-73, 2004
                                                                          9. Rosner JL et al: Imaging of athletic wrist and hand injuries. Semin Musculoskelet Radiol. 8(1):57-79, 2004
                                                                          10. Clavero JA et al: MR imaging of ligament and tendon injuries of the fingers. Radiographics. 22(2):237-56, 2002
                                                                          11. Rajesh A et al: Hand fractures: a study of their site and type in childhood. Clin Radiol. 56(8):667-9, 2001