ABSTRACT
Fractures of phalanges and metacarpals are the most common fractures seen in the Emergency Department. Avulsion fractures at the base of the phalanges can be an indication of more complex injuries. Classic symptoms can be absent in hand fractures. Crepitus or instability can be seen with unintended manipulation. Rotational deformities can be detected by flexion of the MCP joints to 90° and the IP joints stretched. In this position, the nails should align almost parallel. Non-dislocated stable fractures can sometimes be treated by means of ‘buddy taping’ to the adjacent finger during two to three weeks. The growth plates of the phalanges are located at the proximal end. Epiphyseal fractures can be classified according to Salter and Harris. A deviation of less than ten degrees is acceptable when the fracture is located at the base of the proximal phalanx. Deviations are not acceptable in the middle and distal phalanx as the natural correction during growth in these phalanges is minimal.
