Etiology
Phalangeal fractures are often caused by direct traumatic forces, such as heavy objects falling from a height directly onto the toes or striking hard objects while walking. Impact injuries from heavy objects frequently result in comminuted or longitudinal fractures, commonly accompanied by nail bed injuries, with open fractures being more prevalent. Injuries caused by striking hard objects with the toes often result in transverse or oblique fractures. Phalangeal fractures account for 2% of all fractures in adults and 19.2% of all foot fractures.
Treatment
The phalanges are located superficially, making diagnosis after injury relatively straightforward. Non-displaced phalangeal fractures (fracture of the phalanx) typically do not require special treatment. These fractures can be managed with the application of a plaster splint, which allows partial weight-bearing with the splint after 2–3 weeks and removal for full weight-bearing after 6 weeks. Displaced fractures of a single phalanx are managed through manual reduction, followed by fixation of the injured toe to an adjacent toe using adhesive tape, which facilitates early weight-bearing. For most phalangeal fractures, immobilization after reduction with a plaster splint extending beyond the distal end of the toes for 2–3 weeks is sufficient before functional rehabilitation. In the treatment of phalangeal and metatarsal fractures, particular attention is paid to correcting rotational deformities and plantar angulation deformities to prevent functional impairment of the toes caused by alignment abnormalities.