Executive Editor: Chris Colton

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

Middle phalanx

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Glossary

The dorsal approach is indicated for oblique, spiral, comminuted, or transverse fractures of the diaphysis, or metaphysis of the middle ...

Dorsal to the middle phalanx

The dorsal approach is indicated for oblique, spiral, comminuted, or transverse fractures of the diaphysis, or metaphysis of the middle phalanx.
It can also be used for corrective osteotomies of malunited fractures.

Make a skin incision from the middle point between A and B to the middle point between B and C.

Midaxial to the PIP joint

This approach is indicated for intraarticular basal and condylar fractures.

Make a straight midline dorsal incision over the PIP joint.

Dorsal to the PIP joint

The dorsal approach to the proximal interphalangeal (PIP) joint is indicated for intraarticular fractures.
It is also useful for coronal plane fractures of the condyles of the proximal phalanx.
Central slip avulsion fractures from the dorsal base of the middle phalanx are an ideal indication for this approach.

The palmar approach is mainly indicated for  avulsion fractures of the volar plate, and for fracture dislocations of the PIP joint, or for  comminuted impacted  fractures of middle phalanx (pilon) fractures.

Palmar to PIP joint

The palmar approach is mainly indicated for  avulsion fractures of the volar plate, and for fracture dislocations of the PIP joint, or for  comminuted impacted  fractures of middle phalanx (pilon) fractures.

Make a skin incision from A to B. For further exposure, the incision can be extended proximally.

Midaxial to the middle phalanx

The midaxial approach is indicated for long and short oblique fractures, spiral, comminuted, and transverse fractures of the diaphysis and metaphysis of the middle phalanx.

v1.0 2008-11-08