Dislocation of the distal phalanx epiphysis in toddlers.
Two cases of physeal fracture dislocation of the distal phalanx are reviewed. Each injury occurred in a toddler, was originally undiagnosed, and appeared years later as a dorsal mass in a fore-shortened digit with decreased distal interphalangeal joint motion. In each case x-ray films revealed a dislocated epiphysis, accounting for the enlarging dorsal prominence and the phalangeal growth disturbance. These cases demonstrate that dislocation of the distal phalanx epiphysis can occur with a crush injury and may be difficult to detect before development of the ossification center. Careful physical examination and a high index of suspicion will increase the likelihood of early diagnosis. Early open reduction may prevent the late complications of deformity and stiffness.
Waters
P M
PM
Department of Orthopaedic Surgery, Harvard Medical School, Children's Hospital Medical Center, Boston, Mass.
Benson
L S
LS
D002648:Child; D002908:Chronic Disease; D004838:Epiphyses / Q000293:injuries* / Q000601:surgery; D005383:Finger Injuries / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D050723:Fractures, Bone / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D004204:Joint Dislocations / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D008297:Male