Thirty-six digits with an intra-articular fracture of the dorsal aspect
of the distal phalanx that involved one-third or more of the articular
surface were treated by open reduction and internal fixation with Kirschner
wires. After an average length of follow-up of forty-six months,
roentgenograms of the distal joint in twenty-six digits appeared
essentially normal. Ten digits had minor roentgenographic changes but, with
the exception of one digit, the joint space was congruous and free of
significant abnormalities. The average loss of extension of the distal
joint was 2 degrees, and the average arc of flexion of the distal joint was
69 degrees. The average strength of pinch in all digits that were operated
on was essentially equal to the strength of pinch in the contralateral
digit. Exact reduction and internal fixation using the technique described
resulted in excellent motion and function.