title: Volar plating for intra-articular fracture of the base of the proximal phalanx.
abstract: Comminuted fractures involving the articular surface of the base of the proximal phalanx are relatively rare and pose a challenging problem for hand surgeons because of the difficulty in achieving an accurate reduction and secure fixation of the articular surface. These fractures usually comprise a volar base fracture associated with a central depression of the articular surface. We describe a technique for open reduction and plate fixation of intra-articular fractures of the base of the proximal phalanx through a volar A1 pulley approach. Compared with the dorsal approach, this technique offers the advantages of direct visualization of the volar base fragment and the depressed central fragment, allowing for a more accurate reduction and rigid internal fixation using a volar buttress plate. In addition, there is no interference with extensor apparatus. Although our experience is limited to 4 patients, we have had a positive experience with this technique. The technique is useful for internal fixation of intra-articular fractures of the base of the proximal phalanx.
authors.affiliation: Department of Orthopedic Surgery, Ogori Daiichi General Hospital, 862-3 Shimogo, Ogori, Yamaguchi City, Yamaguchi Prefecture 754-0002, Japan. yhattori@saikyo.or.jp
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Hattori
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Doi
authors.forename: Soutetsu
authors.initials: S
authors.lastname: Sakamoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamasaki
authors.forename: Abhijeet
authors.initials: A
authors.lastname: Wahegaonkar
authors.forename: Ahmad
authors.initials: A
authors.lastname: Addosooki
mesh_terms: D001860:Bone Plates; D050278:Finger Phalanges / Q000293:injuries / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D018460:Fractures, Comminuted / Q000601:surgery*; D006801:Humans; D053401:Palmar Plate / Q000601:surgery*