Intraarticular Split Fractures of the Base of the Proximal Phalanx
A violent force that impacts the proximal phalanx against the metacarpal head may split the phalanx. If this happens and the base of the proximal phalanx is fractured into two major fragments that are displaced, one must perform an open reduction and internal fixation to restore the congruity of the articular surface. The metaphysis is reconstructed with one or more 1.5 or 2.0 mm minicortical lag screws. The reconstructed metaphysis is then secured to the diaphysis by plate fixation. Although open fractures are not discussed until Chapter 39, the case illustrated in Figures 23-1 A-M provides an excellent opportunity to demonstrate how a displaced intraarticular split fracture of the base of the proximal phalanx is managed as part of the overall reconstruction of a seriously injured hand.
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