Is there a difference in the types of injuries occurring around each finger joint after a fall?

Abstract

Introduction:

The aims of this study were to gain an understanding of the relative incidences of bone and joint injuries around each finger joint after a fall on the outstretched hand.

Methods:

Injuries at a single hospital over 1 year were recorded and validated by a Delphi review. The Delphi study assessed the perception of consultant hand surgeons about the frequency of peri-articular injuries.

Results:

There were 97 injuries in 95 adults with a mean age of 42 (range 18–91) years. There were 52 men and 43 women. There were 28 injuries around the distal interphalangeal joint, 54 injuries around the proximal interphalangeal joint and 15 injuries around the metacarpophalangeal joint. The commonest injuries were bony mallet injuries, palmar plate injuries and dislocations of the proximal interphalangeal joint and transverse fractures of the base of the proximal phalanx. Seventeen consultant hand surgeons completed the Delphi study. Their responses matched the findings of the 1 year review of the injuries except that they expected many more tendinous mallet injuries.

Conclusion:

The patterns of peri-articular finger injuries differ greatly between the three finger joints. This is explained by the mechanism of falling and the local biomechanical forces.

Level of evidence:

IV