title: Articularly placed interfragmentary screw fixation of difficult condylar fractures of the hand.
abstract: OBJECTIVE
  To retrospectively review the outcomes of intra-articularly placed interfragmentary screws for fixation of difficult condylar fractures of the metacarpal and proximal phalangeal heads.
  
  
  METHODS
  We placed interfragmentary screws intra-articularly in 10 patients with 11 fractures to achieve a rigid fixation construct in which the non-articular portion of the bone fragment is too small to allow a stable fixation, or where the bone fragment is entirely osteochondral.
  
  
  RESULTS
  The mean duration of follow-up was 15.9 months (range, 6-45 mo). All fractures united within 16 weeks (average, 8.1 wk). We observed subsidence in 1 case; another patient had screw protrusion that required removal. The range of motion of the involved metacarpophalangeal joints for the metacarpal head fractures was 79° (range, 60° to 90°). The range of motion of the involved proximal interphalangeal joints for the proximal phalangeal head fractures was 86° (range, 80° to 90°).
  
  
  CONCLUSIONS
  Intra-articularly placed interfragmentary screw fixation is a good technique for treating difficult condylar fractures of the hand.
authors.affiliation: Department of Hand Surgery, Singapore General Hospital, Singapore. jaceug@yahoo.com
authors.forename: Jacqueline S W
authors.initials: JS
authors.lastname: Tan
authors.forename: Anthony T L
authors.initials: AT
authors.lastname: Foo
authors.forename: Winston C Y
authors.initials: WC
authors.lastname: Chew
authors.forename: Lam Chuan
authors.initials: LC
authors.lastname: Teoh
mesh_terms: D000293:Adolescent; D000328:Adult; D001863:Bone Screws; D015331:Cohort Studies; D005260:Female; D005383:Finger Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D005384:Finger Joint / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D015601:Injury Severity Score; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008662:Metacarpophalangeal Joint / Q000293:injuries / Q000601:surgery; D008875:Middle Aged; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D055815:Young Adult