Following an oblique longitudinal impaction, these fractures may involve either proximal or middle phalanx. Typically, the fracture line extends from the inter-condylar notch to the junction of the phalangeal head and neck. These usually require open reduction, and are particularly suited to the use of small (1.0 - 1.3mm) screws as in this case. Because the fragment is small, a helpful technique is to achieve provisional fixation using two Kirschner wires, and then, one at a time, remove the wires and place screws in the wire drill holes (Fig. 4). These fractures are frequently neglected, but if the finger has not been immobilized properly, healing is delayed, and it is usually possible to achieve satisfactory open reduction even several weeks after injury.
Unicondylar Phalangeal Head Fracture