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Palmar to PIP joint

The palmar approach is indicated mainly for volar plate avulsion fractures of the base of the middle phalanx,  ...

Indications

The palmar approach is indicated mainly for volar plate avulsion fractures of the base of the middle phalanx, for fracture dislocations of the proximal interphalangeal (PIP) joint, or for comminuted, impacted fractures of the base of the middle phalanx.
An exception to this rule is a dorsal central slip avulsion fracture of the base of the middle phalanx, with palmar dislocation, that can not be approached via a palmar exposure, and the dorsal route becomes the first choice.
The palmar approach is also indicated for volar plate arthroplasty.