[Fracture of the dorsal distal phalanx or the so-called bony extensor tendon avulsion]

Abstract

Fractures of the distal phalanx are common. According to the histological results of Hoch et al., the term bony extensor tendon avulsion is not correct; instead, the description fracture of the dorsal distal phalanx should be used. Many therapeutic options for these fractures are described in the literature. Decision-making for operative treatment should not only be based on X-rays.Good functional results are mentioned in the literature after conservative treatment of larger bony fragments. The mid- and long-term results of remodelled joints that are mostly not in anatomically correct positions can only be determined in prospective studies. Indications for operative treatment are dorsal distal phalanx fractures with a distal finger joint subluxation or in cases of widely rotational malposition of the bony fragment. The osteosynthesis has to respect the extensor aponeurosis.