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# Distal phalanx, middle finger

The distal phalanx of the middle 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 middle finger

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## What it is

The distal bone of the middle 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 on its dorsal base
- Fingertip crush injuries (a door, a hammer) typically give tuft fractures with nail bed lacerations

## 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 divided into small fat compartments by fibrous septa

**Behind**
Terminal extensor tendon; nail bed and nail plate

## How to find it

Under the tip and nail of the middle finger, which projects furthest and so takes many crush injuries; the nail fold lies just over its base and growth plate in children.

## Examination

- Profundus test: the middle phalanx is held and the person bends the fingertip; loss of DIP flexion means the FDP tendon is cut or pulled off

## On imaging

PA and lateral views of the fingertip. In a child, a widened physis at the base on the lateral view, with a bleeding nail fold, suggests a Seymour fracture.

## Clinical notes

- Infection of the pulp (felon) builds pressure in its closed compartments and can spread to the bone
- In children, a physeal fracture at its base with a nail bed tear (Seymour fracture) is an open fracture

## Development

Its primary centre starts at the tip, early in fetal life; the secondary centre at its base gives a growth plate that stays open until adolescence, the plate involved in a Seymour fracture.

## Related conditions

- [Mallet finger](https://durgical.com/en/conditions/mallet-finger/)

## Test yourself

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

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

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

## What is a felon of the fingertip, and why is it dangerous?

An infection of the pulp; pressure builds in its closed fat compartments and can spread to the distal phalanx.

## What is a Seymour fracture of the distal phalanx?

In children, a physeal fracture at its base with a nail bed tear: an open fracture.

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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 dedo medio

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

## Related

- [Dorsal hand fascia](https://durgical.com/en/anatomy/dorsal-fascia-of-the-hand/)
- [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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