Management of intra-articular fractures of the metacarpophalangeal joint.

Displaced intra-articular fractures of the metacarpal head and of the proximal articular surface of the proximal phalanx often require open reduction and internal fixation, particularly if an articular step off is present. If secure internal fixation can be achieved, early motion may be instituted. Diagnosis may be facilitated by special views and tomography. Secondary reconstructive procedures may include tenolysis, osteotomy, arthroplasty, or tissue transfer from the foot.