Intrafocal pinning for juxtaarticular phalanx fractures.

Juxtaarticular phalanx fractures can present a challenge to the treating physician. Because they are not a common occurrence, we wanted to discuss our treatment protocol for this entity. Goals of treatment include anatomic realignment, fracture stability, and early range of motion. Improper treatment can lead to malunion resulting in deformity or loss of function as well as joint stiffness. Other treatment modalities can also result in unsatisfactory results including decreased range of motion. Intrafocal pinning provides a treatment alternative for the irreducible fracture normally requiring open intervention while satisfying the requirements of fracture stabilization and early range of motion. This technique has been used in 5 patients over the past 3 years without significant complications. Two patients had fractures involving their proximal phalanx, and 3 had middle phalangeal injuries. All patients healed their fractures and maintained functional range of motion (PIPJ 90 degrees, DIPJ 65 degrees).