Fractures and Dislocations of the Phalanges of the Toes
Habib Olapade
UK pre law student; Falsely imprisoned in TX intending to move to CA, HI, or UK upon release.
Fractures of the phalanges of the toes are typically caused by a direct force such as a crush injury. Shaft proximal phalanges spiral or oblique fractures in the lesser toes can occur as a result of an indirect twisting injury. As far as treatment is concerned, comminuted fracture of the proximal phalanx of the great toe, alone or in combination with fracture of the distal phalanx, is a disabling injury. Because wide displacement of fragments is not likely, correction of an angulation and support by a splint usually suffices. A weight bearing removable cast boot can be useful for symptom relief arising from associated soft tissue injury. Spiral or oblique fracture of the proximal or middle phalanges of the lesser toes can be treated by binding the involved toe to the adjacent uninjured toe. Comminuted fractures of the distal phalanx are treated as soft tissue injuries. Dislocation of the metatarsophalangeal joints and dislocation of the proximal interphalangeal joints usually can be reduced by closed manipulation. These dislocations are rarely isolated and usually occur in tandem with other injuries to the forefoot.