Fig. 5. Proximal phalanx fracture fixation. Typically, fractures of the shaft of the proximal phalanx displace in an apex volar pattern (1.). Depending on the patient and the fracture patterns, these may be treated with dorsal extension block splinting (2.), percutaneous intramedullary pins, here augmented by bonding the protruding ends together to form an external fixation construct for additional stability (3a,b.), open reduction with pins, compression wires or mini plates (4,5.). Extreme comminution or segmental bone loss may require primary segmental bone grafting (6.), ingenious internal (7.) or external fixation (8.)