The Journal of Bone and Joint Surgery, Vol 69, Issue 6 892-896, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
Operative treatment of intra-articular fractures of the dorsal aspect of the distal phalanx of digits
HH Stark, BJ Gainor, CR Ashworth, NP Zemel and TA Rickard
Thirty-six digits with an intra-articular fracture of the dorsal aspect of
the distal phalanx that involved one-third or more of the articular surface
were treated by open reduction and internal fixation with Kirschner wires.
After an average length of follow-up of forty-six months, roentgenograms of
the distal joint in twenty-six digits appeared essentially normal. Ten
digits had minor roentgenographic changes but, with the exception of one
digit, the joint space was congruous and free of significant abnormalities.
The average loss of extension of the distal joint was 2 degrees, and the
average arc of flexion of the distal joint was 69 degrees. The average
strength of pinch in all digits that were operated on was essentially equal
to the strength of pinch in the contralateral digit. Exact reduction and
internal fixation using the technique described resulted in excellent
motion and function.