Intraarticular fractures of the proximal phalanx of the thumb must be treated radically to avoid:
- loss of motion
- post-traumatic arthrosis
Articular congruity should be restored anatomically. In cases of comminuted impacted fractures (“pilon”), bone graft from the distal radius is needed to fill the metaphyseal defect resulting from elevation of the depressed fragments.
It is difficult to assess the extent of articular comminution from plain radiographs. A CT scan is advisable.