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4Reduction and plate fixation

Pearl: Plate selection

For a multifragmentary fracture comprised of a small distal articular rim fracture, a palmar plate which directs the very distal screws proximally may be applicable.

As the screws are placed in a very subchondral manner, there is a high risk that there may be some inadvertent penetration of the joint. Special care must be taken to exclude this with imaging.

As the plate is so distal, flexor tendon irritation is common and so this plate usually must be removed.