Causes / typical injury mechanism: Distal phalanx fractures are common hand injuries that result from trauma. In patients aged 10-29 years, distal phalanx fractures are most commonly from sports injuries. In patients aged 40-69 years, accidents involving machinery are the most common cause. In patients older than 70 years, falls are the most common cause.

Classic history and presentation: Patients will present with acute pain, swelling, and possible nail bed injury following a direct trauma. The finger may appear grossly angulated or displaced.

Prevalence: Phalanx fractures are the most common injuries to the skeletal system, accounting for 10% of all fractures.

• Age – All ages
• Sex / gender – 2:1 male-to-female ratio

Risk factors:

• Osteoporosis
• Fall risk
• Working with heavy machinery
• Participating in sports

Pathophysiology: Distal phalanx fractures are caused from bending or torsional forces associated with trauma.

Grade / classification system: There is no specific classification system; however, the fractures can be subclassified based on location –

• Tuft fractures involve a comminuted distal phalanx fracture often resulting from a crush injury.
• Shaft fractures involving the phalanx shaft are often described as transverse or longitudinal.
• Base fractures involve either the volar or dorsal base of the distal phalanx.
• Seymour fractures describe an epiphyseal injury in the pediatric population with an associated nail bed injury.