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Short oblique shaft fractures of the proximal phalanx – Compression plate fixation

Pitfall: avoiding excessive screw length

Remember that the palmar cortex of the phalanx is slightly concave, where it forms the bony roof of the flexor tunnel. For this reason, lateral x-ray images can deceive the surgeon in terms of appropriate screw length, as illustrated here. The screw of the correct length will appear, on a lateral x-ray, to be about one thread pitch short of the palmar cortical image.