Operative management of intra-articular distal interphalangeal joint fractures of the hand.

The management of intra-articular fractures of the hand represents a challenge. Large articular fragments require reduction and operative fixation. A number of surgical techniques have been described in literature, with variable results. Distal interphalangeal joint fractures have been fixed by various methods including screw, plate and suture techniques. Generally operative fixation is indicated when more than 30% of the articular surface is involved with or without subluxation of the joint. The aim of surgery is to reduce the fracture fragments anatomically whilst providing osseous stability, and to commence early active movement of the joint to prevent stiffness. In this review we aim to summarise the main management options for intra-articular distal interphalangeal fractures, placing particular emphasis on surgical treatment.