Executive Editor: Joseph Schatzker, Richard Buckley

Authors: Michael Castro, Richard Buckley, Andrew Sands, Christina Kabbash

Phalanges - 2nd-5th row, proximal phalanx, excessively displaced

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1 Nonoperative treatment top


In most cases, the fracture is manually reduced and stabilized with buddy taping.

2 Reduction and K-wire fixation top


Patient preparation

This procedure is normally performed with the patient in a supine position.


Closed reduction and fixation

The toe is manually reduced by applying traction to the fracture. A 1.25 mm or 1.6 mm K-wire is placed across the DIP and PIP joints, and manually reduced MTP joint.

Fluoroscopic assistance during this procedure is necessary.


Open reduction and fixation

If unable to reduce the toe with manual reduction, a small dorsal incision over the fracture site may be utilized and the fracture disimpacted and reduced with a Freer elevator.

v2.0 2017-03-23