Seno N, Hashizume H, Inoue H, Imatani J, Morito Y
Okayama University Medical School and Okayama Saiseikai General Hospital, Japan.
J Bone Joint Surg Br. 1997 Sep;79(5):758-63. doi: 10.1302/0301-620x.79b5.7664.
We classified fractures of the base of the middle phalanx into five types: 1) single palmar fragment; 2) single dorsal fragment; 3) two main fragments; 4) not involving the articular surface, including epiphyseal separation in children; and 5) all others. Types 1 and 2 were subclassified into avulsion, split and split-depression. Surgery is recommended for unstable type-1 avulsion fractures, type-2 avulsions which may develop buttonhole deformities, and all fractures which displace articular cartilage surfaces. Long-term follow-up showed that surgical treatment which produced good stability and congruity gave good results. These should be the primary aims of treatment.
