Twenty-one patients with fractures of the bones of the hand were treated
by open reduction and internal fixation with compression screws. The firm
fixation allowed range-of-motion exercises in most patients to be begun on
the third postoperative day. On follow-up mild restriction in digital
motion was seen in only one patient, and significant disturbance in joint
function was not encountered. In spite of these advantages, the method is
indicated in only a small percentage of such fractures. Usually traditional
methods of open reduction and internal fixation are preferred when an open
procedure is needed. However, oblique and spiral fractures of the proximal
phalanx, some fractures with large single articular fragments particularly
involving the proximal interphalangeal joint, and appropriate Bennett's
fractures are suitable for screw fixation.