Two tuft fractures of the distal phalanx had a unique fracture pattern with significant displacement of the proximal fracture fragment into the pulp of the finger. Both fractures were irreducible by closed means, probably due to entrapment of bony spikes within the fibrous septa of the pulp or overlapping of the proximal and distal fracture fragments.
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Qattan et al. (2003) studied this question.
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