Tuft Fractures

Tuft Fractures (by Clare Black)

Tuft Fractures

Mechanism of Injury

Tuft fractures are usually caused by a crush injury such as getting the finger caught in a door or dropping a heavy weight on the finger tip. Sometimes the nail or nail bed can also be injured.

Symptoms

• Bruising and swelling of the fingertip
• Pain
• Hypersensitivity at the fingertip and/or nailbed

Diagnosis

X-ray is required to confirm the diagnosis.

Photo source: Orthobullets

Referral

The referral should be made soon as the injury is diagnosed, preferably immediately post injury. Most tuft fractures are considered stable as the fracture is at the distal aspect of the bone, beyond where the tendons insert. If there is an open injury or wound, it is also recommended to refer the patient to a hand surgeon for review.

Management

• A custom made thermoplastic splint is made for the fingertip for protection and to manage sensitivity
• Oedema management
• Mobilisation of both interphalangeal joints to prevent stiffness
• Desensitisation program and pain management

Splinting

Finger Splint