The distal phalanges bear the toenails and the terminal skin of the toes, providing the final lever for toe push-off during gait and the attachment site for the distal tendons of the flexors and extensors of the toes.
| Articulations |
|
|---|---|
| Landmarks |
|
| Ossification | Endochondral ossification, variable secondary centres. |
Distal toe phalanges are commonly bruised under the nail from stub injuries, producing painful subungual haematomas. Ingrown toenail involving the great toe nail growing into the lateral nail fold is treated by nail edge avulsion and phenolisation of the germinal matrix. Distal phalanx osteomyelitis from penetrating injuries through the toenail is a risk in diabetic patients.
Heavy objects dropped on the toe fracture the distal phalanx, often with a subungual haematoma or nail bed injury.
Flexion deformity at the distal interphalangeal joint of a lesser toe causes a painful callus on the tip.
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