Marginal fracture of the phalanges of the fingers and toes: Types, Causes, Signs, Diagnosis, Treatment, Rehabilitation, Prevention


Any fracture can have unpleasant consequences, even if it is a broken toe. Knowing what to do when you break your toe can help you navigate a difficult situation. Read our first aid tips - and you will have a clear idea of ​​how to diagnose a fracture (we'll tell you about its characteristic signs and symptoms) and how it can be cured.

A broken toe requires immediate medical attention. Its treatment is long and complex. If you want to avoid a number of inconveniences (for example, difficulty moving due to improperly fused bones), you need to learn how to promptly determine the presence of a fracture. Incorrect treatment can cause loss of the previous shape and flexibility of the limb. Therefore, at the first suspicion of a fracture, it makes sense to consult a doctor.

Fractured toe: causes and symptoms

Most often, the phalanges of the fingers are injured when an object that is too heavy falls, due to a strong blow or an accidental twisting of the leg. In some cases, fractures occur due to diseases such as osteomyelitis (bone infection), diabetes, cancer, osteoporosis.

Most fractures are stress fractures: a microcrack occurs that does not cause rupture of the skin or displacement of bones. Less common are comminuted fractures: the bone breaks in several places. Diagnosing an open fracture is easy: you will see bones sticking out. Correctly assessing the severity of the injury allows you to determine the appropriate treatment.

The main symptoms of a broken toe include:

  • visible swelling;
  • unbearable pain;
  • deformation of the phalanx;
  • bruises, hemorrhages;
  • crunching sound when trying to move the leg;
  • tingling, cooling, numbness;
  • an open wound accompanied by bleeding.

Having broken the thumb, a person cannot fully walk, because it is this finger that bears most of the body weight. A broken little finger does not deprive a person of the ability to walk. But in both cases, the pain will be noticeable.

Classification of injury

Fractures of the fingers can be closed or open, which can be:

  • single-segmented;
  • multi-spined;
  • fragmented;
  • splinterless.

By type of bone displacement:

  • Corner. When the proximal phalanx is fractured, the axis of the bone changes;
  • lateral displacement formed along the width. With such a violation, bone fragments move in different directions;
  • longitudinal displacement. With it, the broken parts of the bone move along the bone axis.

Rotation injuries are especially dangerous.

When even the index finger is fractured, the shape of the damaged finger is disrupted.

Along the fault line, damage is divided into:

  • oblique;
  • longitudinal;
  • helical;
  • transverse;
  • T-shaped.

Damages along the fault line zone include:

  • periarticular;
  • intra-articular.

A separate category includes injuries that deform the diaphyseal part of the arm. Doctors call them “extra-articular”.

What complications are possible after a broken toe?

Do not think that an injury to the phalanx of a finger is a trifle. A number of problems arise after an injury. If there is a hematoma, the nail may be removed. In case of improper tissue fusion, surgical intervention is required: an osteotomy is performed to eliminate deformation of the joints and bones.

In addition, there is a risk of infection if there is inflamed skin next to the broken finger. The presence of redness, swelling, pus, as well as soft tissue and increased temperature are evidence of infection. In this case, you cannot do without antibiotics.

In order to avoid the consequences of a fracture, you need to seek medical help from qualified specialists. Diagnosis and treatment of injured limbs is carried out not only by chiropractors and orthopedists, but also by osteopathic doctors and physiotherapists. Specialists make diagnoses after examination and examination of x-rays. In some cases, a computed tomography, MRI, ultrasound, or bone scan is required.

First aid

Initially, a clamp is attached to the victim’s sore finger. It prevents the separation of bone fragments. It is made from improvised, hard materials.

An open fracture of the nail plate is treated with a bandage soaked in an antiseptic solution. Chlorhexidine can be used as a solution. This treatment prevents pathogenic bacteria from entering the wound. It is carried out if the patient is not taken to a medical facility for a long time.

Next, the patient should be given an anesthetic. This could be a tableted anti-inflammatory medication. For example, Ketorolac.

Remember that some actions with the victim are prohibited. For example, he cannot:

  • independently adjust damaged limbs and insert them into the wound canal;
  • rotate, straighten, bend the injured limb. Due to this, bone fragments can move;
  • bandage the injured area tightly, even if there is no bleeding. This action disrupts blood circulation. Because of this, gangrene may develop;
  • take medications without consulting a doctor.

Features of the treatment of broken toes

If we are talking about a stress fracture, then the first thing you will need to do is stop any activity and apply an ice compress to the damaged area (it will reduce inflammation and stop internal bleeding). Ice should be applied for 10-12 minutes every hour. Experts recommend keeping the injured limb elevated; it can be placed on a blanket or pillow. You will definitely need to bandage the broken finger, connecting it to the adjacent one. An ordinary medical waterproof bandage will do for this. Your family doctor will recommend anti-inflammatory medications. For the next 5-6 days you will have to wear shoes with loose toes.

An open fracture requires the help of an orthopedic surgeon. He will reduce the broken finger and apply a splint. You will need to use crutches for approximately 2 weeks. For walking you will need to purchase special orthopedic shoes. Anyone who wants to quickly recover from a fracture should eat foods that are rich in vitamins, minerals, magnesium, calcium, and boron.

Important point! Almost always, if there is an open wound, doctors recommend getting a tetanus shot.

Practice shows that it takes about 1.5 months to heal broken fingers.
If the problem is not resolved within this period, the doctor will take new x-rays and adjust the treatment. Only an expert can qualitatively assess the degree of bone healing. Despite the fact that the fractures in question heal easily, the consequences should not be forgotten. You don't want to develop arthritis, do you? Don't want to get a disability? If you experience the slightest injury, consult a doctor immediately.

Diagnostics

A traumatologist can easily diagnose such a fracture based on examination data. To confirm the diagnosis, an x-ray examination is performed.

In the photographs you can see the number of fragments, the fracture line, the location of the injury, and the presence of small fragments. Once the diagnosis is established, appropriate treatment is prescribed.


A fracture is diagnosed using an x-ray

A little about anatomy

Fingers belong to the hand, which consists of three sections:

  • wrist;
  • metacarpus;
  • fingers.

The fingers, except the thumb, consist of three phalanges - proximal, middle and distal. The phalanges are represented by tubular bones. Each phalanx has a head and a base.

The middle, thinnest part of the bone is called the body of the phalanx. The joints of the head and adjacent phalangeal bones form the interphalangeal joints.


The fingers are formed by phalanges

Thanks to their fingers, people are able to grasp and hold various objects, write, draw, perform precise manipulations, and gesture.

At-risk groups

A fracture of the thumb occurs quite often in the following categories of citizens:

  • Children.
  • Professional athletes who most often play basketball, boxing or volleyball.
  • Patients with osteoporosis.
  • Elderly.
  • People working with dangerous machines.
  • Women who are going through menopause.

Residual effects

You can hear from some patients that after a fracture their finger hurts or cannot bend. For pain relief, patients are recommended to use non-narcotic analgesics in tablets (Paracetamol, Analgin, Pentalgin). When the patient's ligaments are not developed, it will be difficult for him to bend his finger. If all the bones of the thumb are fused correctly, then paraffin applications, massage and physical therapy are prescribed, and ointments such as Piroxicam or Chondroxide must be rubbed into the finger.

Rehabilitation

Immobilization takes 2-3 weeks. Additional recommendations:

  • limit sudden and very active movements;
  • do not play sports;
  • do not stay on your feet for a long time;
  • include in your diet the maximum amount of foods that contain a lot of protein and calcium.

To speed up the rehabilitation process, you can connect:

  • massotherapy;
  • physiotherapeutic procedures;
  • gymnastic exercises.

All of the above activities are carried out only according to the clear instructions of the attending physician.

Case study No. 1

A girl whose phalanx of her finger fused incorrectly described her complaints like this:

“If the hand is at rest, there is a pulling sensation in the finger somewhere from the middle of the palm, as if it is heavier than the rest, or as if stiff, this does not bother you, it is just noticeable. When vibrating, shaking a finger, it hurts from slightly to very much, for example, if you touch something with your hand (not hit, but lightly) - get caught on clothes, hand in hand, furniture - it already hurts, I wince, but tolerable. My husband suddenly took my hand - I screamed, there was sharp pain. Holding a weighty object (salad bowl, book) in your hand (4 fingers at the bottom, big at the top) hurts, I immediately grab it with my other hand. I unclench my fist after I bring the bag from the store and have to endure it for a couple of minutes until the pain subsides - although the load seems to be greater on the other fingers, and it didn’t hurt to carry it. At the same time, it hurts to bend and unbend a finger only if you try to do it with effort, further than he can do” (the author’s spelling and punctuation have been preserved).

The image clearly shows a displacement along the articular surface of the middle phalanx, which was not eliminated during treatment of the fracture.

In this case, corrective osteotomy is impossible and plastic surgery was performed with an osteochondral graft from the hamate bone (hemi-hamate arthroplasty).

In this operation, a piece of bone with cartilage from the hamate is taken, which is ideal for replacing a defect in the articular surface of the base of the middle phalanx.

This is what the finger looks like after surgery.

Three months later, the girl wrote about him in a completely different way:

“I perform all the actions that I couldn’t do with my hand before the operation because of pain in the finger without any problems, the only slightly painful sensations are when I try to fully bend it and immediately straighten it completely and vice versa, but the pain is not sharp and goes away immediately.

The set of rehabilitation exercises that the doctor showed me at the handclinic began slowly - now I perform it much more actively, the strength in the finger is almost on par with the rest, plus the steering wheel (a good compression trainer), plus briefcases - I use my hand actively, even the muscle of the left forearm is already aligned with the right, otherwise I compared them in August by accident, I was quite surprised at how weak my left arm was in six months after the fracture.

As far as I understand your forecasts, things with the finger are, in principle, as expected.”

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