ABSTRACT
Phalanx fractures and dislocations are some of the most common musculoskeletal injuries. This chapter addresses the management of phalanx fractures in the elderly. The metacarpophalangeal joint is a condylar joint that can move along two axes including flexion/extension and radial/ulnar deviation. The distal phalanx is most the commonly fractured phalanx. The long finger distal phalanx is the most common because its length makes it more vulnerable. Intra-articular base fractures of the proximal phalanx with substantial displacement or malalignment can be treated with open reduction and internal fixation. The irreducible Proximal interphalangeal dislocation is usually due to incarceration of a collateral ligament in the joint. K-wires are commonly used for fixation usually after closed reduction but sometimes after open reduction. For short oblique and transverse fractures, the finger is distracted and reduced under fluoroscopy guidance. The treatment of phalangeal fractures and dislocations aims for adequate alignment and motion, and a durable articulation.
