Transverse extraarticular or diaphyseal fracture

Simple transverse metaphyseal and shaft fractures of the middle phalanges are classified according to AO/OTA as 78.2–5.2.1A, 2A, and 3A, respectively, where 2–5 indicates which finger is injured.

$Illustration of transverse extraarticular and diaphyseal fractures of the middle phalanx, AO/OTA 78.2–5.2.1A, 2A, 3A.$

Rotational deformity

In fractures distal to the proximal interphalangeal (PIP) joint, overlap of neighboring fingers may occur when there is substantial rotational displacement.

$Illustration of oblique extraarticular and diaphyseal fractures of the middle phalanx, overlap may occur with rotational displacement.$

Outcomes

Outcome of fractures of the middle phalanx is usually more favorable than those of the proximal phalanx. This is largely because limitations in distal interphalangeal (DIP) joint motion are not such a disability as similar stiffness of the PIP and metacarpophalangeal (MCP) joints.

AP and lateral x-rays should be taken.

In this case, the distal fragment has tilted dorsally. There is an additional oblique fracture in the diaphysis of the phalanx.

$Illustration of transverse extraarticular and diaphyseal fractures of the middle phalanx, AP and lateral x-rays show dorsal tilt of distal fragment and additional oblique fracture in diaphysis.$