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.
|Totally nondisplaced condylar fragments|
- The vast majority of bicondylar fractures
|Lag screw fixation|
|Displaced and/or unstable bicondylar fractures|
- Very short metaphyseal segments
|Basic surgical experience, no specialized skills|
|Some specialized surgical experience|
|Highly experienced and skilled surgeon|
|Basic equipment only|
|Simple surgical and imaging resources|
|Full specialized surgical and imaging resources|