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# Proximal phalanx, middle finger

The proximal phalanx of the middle finger is its first bone beyond the knuckle; small hand muscles on both sides move it side to side.

Official name: Proximal phalanx of the middle finger

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## What it is

The proximal bone of the middle finger.

## What it does

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

## Key points

- The middle finger has two dorsal interossei (second and third), one on each side of its proximal phalanx, and no palmar interosseous
- Proximal phalanx fractures angulate apex palmar and can rotate; the A2 pulley lies over the shaft

## Key facts

**Joints with**
Metacarpal head (MCP joint), next phalanx (IP joint)

**Landmarks**
Base, shaft, head (condyles)

## Relations

**Above**
Head of the [3rd metacarpal](https://durgical.com/en/anatomy/3rd-metacarpal/) at the MCP joint

**In front**
FDS and [FDP tendons](https://durgical.com/en/anatomy/flexor-digitorum-profundus-tendons/) under the A2 pulley

**Lateral**
Second dorsal interosseous and the second lumbrical

**Medial**
Third dorsal interosseous

## How to find it

The longest proximal phalanx, on the [axis](https://durgical.com/en/anatomy/axis/) of the hand: the middle finger is the reference line for abduction and adduction of the other fingers, which move away from or toward it.

## Examination

- Finger cascade and nail alignment with the fingers half-bent: a rotated fracture makes the middle finger overlap the index or ring finger

## On imaging

PA and true lateral views of the middle finger; on the PA view the base and shaft can be hidden by the adjacent fingers unless they are spread.

## Clinical notes

- Rotational malunion makes the middle finger cross a neighbour when a fist is made
- Flexor tendon adhesions over the shaft are a common cause of stiffness after these fractures, so early guarded motion is part of most treatment plans

## Development

One primary centre in the shaft before birth and one secondary centre at its base; until that growth plate closes in adolescence, base fractures in children cross the physis.

## Related conditions

- [Scabies](https://durgical.com/en/conditions/scabies/)
- [Trigger finger](https://durgical.com/en/conditions/trigger-finger/)

## Test yourself

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

## Which interossei attach to the proximal phalanx of the middle finger?

The second and third dorsal interossei, one on each side; the middle finger has no palmar interosseous.

## Which pulley lies over the shaft of the proximal phalanx of the middle finger?

The A2 pulley, over the flexor digitorum superficialis and profundus tendons.

## In which direction do proximal phalanx fractures of the middle finger angulate?

Apex palmar, and they can rotate, making the finger cross a neighbour in a fist if malunited.

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

## Its names

**Official Latin (TA2)**
phalanx proximalis manus TA2 1277

**Official Spanish (DeCS)**
Falange proximal del dedo medio

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

## Related

- [Digital arteries](https://durgical.com/en/anatomy/palmar-digital-arteries/)
- [A1 pulleys](https://durgical.com/en/anatomy/a1-pulleys-of-the-flexor-tendon-sheaths/)
- [Dorsal interossei](https://durgical.com/en/anatomy/dorsal-interossei/)
- [FDP tendons](https://durgical.com/en/anatomy/flexor-digitorum-profundus-tendons/)
- [FDS tendons](https://durgical.com/en/anatomy/flexor-digitorum-superficialis-tendons/)
- [Finger joint capsules](https://durgical.com/en/anatomy/finger-joint-capsules/)
- [Finger pulleys](https://durgical.com/en/anatomy/flexor-tendon-sheaths-and-pulleys/)
- [Flexor tendon sheaths](https://durgical.com/en/anatomy/flexor-tendon-synovial-sheaths/)

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