Executive Editor: Chris Colton

Authors: Renato Fricker, Matej Kastelec, Fiesky Nuñez, Terry Axelrod

Thumb - Proximal phalanx: Base and shaft - pilon fractures

General considerations

Intraarticular fractures of the proximal phalanx of the thumb must be treated radically to avoid:

  1. loss of motion
  2. 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.

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v1.0 2008-11-08