Authors of section

Authors

Aida Garcia, Fabio A Suarez

Executive Editor

Simon Lambert

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Wedge/multifragmentary fracture of the diaphysis

Definition

Fragmentary or comminuted shaft fractures of the proximal phalanges may be wedge (AO/OTA 78.2–5.1.2B) or multifragmentary (78.2–5.1.2C), where 2–5 indicates which finger is injured.

AP view of a wedge and a multifragmentary fracture of the diaphyseal phalanx - Proximal phalanx hand

Further characteristics

Comminuted fractures are rarely isolated injuries, as they usually result from high-energy trauma (crushing). Soft-tissue lesions are frequently associated with the potential risk of edema, fibrotic reactions, and eventual stiffness.

The degree and type of comminution depend on the forces and energy that acted on the finger.

Comminuted fractures

Even in the hand, which is well vascularized, small fragment comminution means poor soft-tissue attachment to the fragments and, thereby, biological compromise.

AP and lateral views of a multifragmentary fracture of the diaphyseal phalanx - Proximal phalanx hand

Wedge fracture

In some cases, a large wedge fragment may result from the injury. In such cases, vascularity has not usually been significantly compromised.

AP and lateral views of a multifragmentary wedge fracture of the diaphyseal phalanx - Proximal phalanx hand

Imaging

AP x-ray of a wedge fracture of the 5th proximal phalangeal shaft

73 D320 Definition

Lateral x-ray

x-ray of a wedge fracture of the 5th proximal phalangeal shaft
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