Proximal phalanx shaft fractures

These typically result in dorsal angulation (apex volar) because of the palmar force of the intrinsic muscles on the proximal fragment and the dorsal force of the extensor mechanism on the distal fragment. These are generally unstable unless the force of the intrinsic muscles can be counteracted. They are commonly treated either by reduction and percutaneous fixation with longitudinal intramedullary Kirschner wires, open reduction with intraosseous wires and Kirschner wires, or open reduction and fixation with mini plates and screws (Fig. 5). In either case, early motion of the proximal and distal interphalangeal joints is needed to prevent stiffness.
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