Distal phalanx fractures are the most common fractures in the hand. They are usually a result of crush or shearing forces.  In adults, these are commonly work-related injuries.

Because of severe crush mechanisms, the tuft is often comminuted and there is significant soft tissue injury.  

The distal phalanx contains fibrous septa that contain the fracture fragments and soft tissue swelling, but also contribute to the severe pain associated with these fractures.