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Intraarticular Split Fractures of the Base of the Proximal Phalanx

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Stable Fixation of the Hand and Wrist

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Abstract

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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Authors and Affiliations

  1. Section of Hand Surgery, University of Mississippi Medical Center, Jackson, Mississippi, USA

    Alan E. Freeland M.D. (Professor and Chief, Attending Staff)

  2. Jackson Veteran’s Administration Hospital, Mississippi Methodist Rehabilitation Center, Blake Clinic for Crippled Children and Mississippi Children’s Rehabilitation Center, Jackson, Mississippi, USA

    Alan E. Freeland M.D. (Professor and Chief, Attending Staff)

  3. Division of Plastic Surgery, University of Mississippi Medical Center, Jackson, Mississippi, USA

    Michael E. Jabaley M.D. (Clinical Professor, Attending Staff)

  4. St. Dominic’s-Jackson Health Services Center, Mississippi Baptist Medical Center, River Oaks Hospital, Mississippi Methodist Rehabilitation Center, Jackson, Mississippi, USA

    Michael E. Jabaley M.D. (Clinical Professor, Attending Staff)

  5. Division of Orthopaedic Surgery, University of Mississippi Medical Center, Jackson, Mississippi, USA

    James L. Hughes M.D. (Professor and Chief, Attending Staff)

  6. Jackson Veteran’s Administration Hospital, Mississippi Methodist Rehabilitation Center, Blake Clinic for Crippled Children and Mississippi Children’s Rehabilitation Center, Jackson, Mississippi, USA

    James L. Hughes M.D. (Professor and Chief, Attending Staff)

Authors
  1. Alan E. Freeland M.D.
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  2. Michael E. Jabaley M.D.
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  3. James L. Hughes M.D.
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© 1986 Springer-Verlag New York Inc.

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Freeland, A.E., Jabaley, M.E., Hughes, J.L. (1986). Intraarticular Split Fractures of the Base of the Proximal Phalanx. In: Stable Fixation of the Hand and Wrist. Springer, New York, NY. https://doi.org/10.1007/978-1-4613-8640-7_23

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  • DOI: https://doi.org/10.1007/978-1-4613-8640-7_23

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4613-8642-1

  • Online ISBN: 978-1-4613-8640-7

  • eBook Packages: Springer Book Archive

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