Intra-articular fractures of the metacarpophalangeal and proximal interphalangeal joints.

When displaced or unstable, intra-articular fractures of the metacarpophalangeal and proximal interphalangeal joints represent difficult management problems. The best results can be achieved only with near-anatomic restoration of the joint surfaces and early active motion exercises. These principles dictate the use of rigid internal fixation by means that are not compromised by the exercise program. Not all of these serious injuries, regardless of how they are treated, will do well. Salvage procedures represent considerable functional compromise. Therefore, the most reliable techniques must be used in the initial treatment of these uncommon injuries.