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Reduction

Hyperextend the distal phalanx to gain maximal visualization of the joint (open book).

Visualize the joint

Hyperextend the distal phalanx to gain maximal visualization of the joint (open book).
In order to gain better visualization of the fracture, use a syringe to clean out blood clots with a jet of water.
Evaluate fracture geometry and look for comminution or impaction.
Often, comminution is not apparent from the x-rays, and can only be determined under direct vision.