Annual Report

Executive Editor: Chris Colton

Authors: Fiesky Nuñez, Renato Fricker, Matej Kastelec, Terry Axelrod

Middle phalanx - Distal, bicondylar

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Glossary

General considerations

Bicondylar fractures of the head of the middle phalanx may be T-shaped, with a long, or a short, T.

Typically these fractures are the results of axial load combined with lateral angulation of the finger.

Bicondylar fractures tend to be very unstable and should be treated operatively. If conservative treatment is attempted, secondary displacement is likely, leading to angulation of the finger.

Lag screw fixation is indicated both for the short T-shaped and the reversed lambda fractures.

Nonoperative treatment
Main indication Skill Equipment
Totally nondisplaced condylar fragments Basic surgical experience, no specialized skills Basic equipment only

Contraindications

  • The vast majority of bicondylar fractures
Lag screw fixation
Main indication Skill Equipment
Displaced and/or unstable bicondylar fractures Highly experienced and skilled surgeon Simple surgical and imaging resources

Contraindications

  • Very short metaphyseal segments
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

v1.0 2008-11-08