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# Distal phalanx, index finger

The distal phalanx of the index finger is the bone of the fingertip; the deep flexor and the end of the extensor tendon attach to its base.

Official name: Distal phalanx of the index finger

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## What it is

The distal bone of the index finger. It carries the nail and the fingertip pad.

## What it does

One of the finger bones; the joints between them let the finger curl.

## Key points

- FDP inserts on its palmar base and the terminal extensor tendon on its dorsal base
- The index has its own FDP muscle belly, so it can flex its DIP joint independently of the other fingers

## Key facts

**Joints with**
Middle phalanx (DIP)

**Landmarks**
Base (FDP/FPL insertion, terminal extensor), tuberosity under the nail

## Relations

**Above**
Head of the middle phalanx at the DIP joint

**In front**
FDP tendon to the base; the fingertip pulp, rich in digital nerve endings, used in fine pinch

**Behind**
Terminal extensor tendon at the base; the nail bed and germinal matrix

## How to find it

The bone under the index fingertip and nail; the palmar pulp over it is the classic autonomous sensory area of the [median nerve](https://durgical.com/en/anatomy/median-nerve/), used to check that nerve.

## Examination

- Profundus test: with the middle phalanx held still, the person bends the fingertip; no active DIP flexion means the FDP tendon is cut or avulsed

## On imaging

A lateral view shows a mallet fragment from the dorsal base and whether the distal phalanx has slipped palmarward; a tuft fracture is seen best on the PA view.

## Clinical notes

- Mallet finger: the terminal extensor tears or avulses a dorsal fragment, leaving the DIP flexed
- Tuft fractures from crush injuries often come with nail bed injury
- Paronychia or a pulp abscess over it can reach the bone and cause osteomyelitis of the tuft when drainage is late

## Development

Distal phalanges are among the first bones of the hand to ossify; the primary centre appears at the tip (the tuft) and a secondary centre forms at the base.

## Related conditions

- [Psoriasis](https://durgical.com/en/conditions/psoriasis/)
- [Viral warts (verruca)](https://durgical.com/en/conditions/viral-warts/)
- [Psoriatic arthritis](https://durgical.com/en/conditions/psoriatic-arthritis/)
- [Hypertrophic osteoarthropathy and digital clubbing](https://durgical.com/en/conditions/hypertrophic-osteoarthropathy-and-digital-clubbing/)
- [Hand infections (paronychia, felon, flexor tenosynovitis)](https://durgical.com/en/conditions/hand-infections/)

## Test yourself

Think of the answer, then tap the question to see it.

## Which tendons insert on the distal phalanx of the index finger?

Flexor digitorum profundus on the palmar base and the terminal extensor tendon on the dorsal base.

## Why can the index finger flex its DIP joint independently of the other fingers?

The index has its own flexor digitorum profundus muscle belly.

## What is mallet finger?

The terminal extensor tears or avulses a dorsal fragment of the distal phalanx, leaving the DIP flexed.

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Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
phalanx distalis manus TA2 1279

**Official Spanish (DeCS)**
Falange distal del índice

**English (TA2)**
Distal phalanx of the index finger

## Related

- [FDP](https://durgical.com/en/anatomy/flexor-digitorum-profundus/)
- [FDP tendons](https://durgical.com/en/anatomy/flexor-digitorum-profundus-tendons/)
- [Finger joint capsules](https://durgical.com/en/anatomy/finger-joint-capsules/)
- [Finger collateral ligaments](https://durgical.com/en/anatomy/collateral-ligaments-of-the-finger-joints/)
- [Volar plates (fingers)](https://durgical.com/en/anatomy/volar-plates-of-the-interphalangeal-joints/)

Sources: Terminologia Anatomica (TA2); [Anatomy, Shoulder and Upper Limb, Hand Bones](https://www.ncbi.nlm.nih.gov/books/NBK547684/); [8.2 Bones of the Upper Limb](https://openstax.org/books/anatomy-and-physiology-2e/pages/8-2-bones-of-the-upper-limb) (OpenStax (Rice University), 2022) · adapted, [CC BY 4.0](https://creativecommons.org/licenses/by/4.0/); [8.5 Development of the Appendicular Skeleton](https://openstax.org/books/anatomy-and-physiology-2e/pages/8-5-development-of-the-appendicular-skeleton) (OpenStax (Rice University), 2022) · adapted, [CC BY 4.0](https://creativecommons.org/licenses/by/4.0/); Anatomy of the Human Body (20th ed.): Articulations of the Digits (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain.

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/anatomy/distal-phalanx-of-the-index-finger/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/distal-phalanx-of-the-index-finger/