Pilon fractures of middle phalanx managed with lag screw and early mobilisation
Background: Injury following proximal interphalangeal joint fracture dislocation is determined by the direction of force transmission and the position of the joint at the time of impact. Dorsal dislocations with palmar lip fractures are the most frequently encountered. The degree of stability is directly determined by the amount of middle phalangeal palmar lip involvement.rnMethods: Case series of five patients who presented between Jan to June 2015 with pilon fracture of the middle phalanx. Mechanism of injury was axial loading onto to the proximal interphalangeal joint, while playing Australian football. All of them presented within 3 days of their initial injury with fracture of the volar lip of base of middle phalanx with dorsal subluxation. All of them underwent open reduction via the shot gun approach and fixation with 1.3mm lag screw. rnResults: Post operatively they underwent early mobilisation within the volar plate protocol and good outcome in terms of proximal interphalangeal joint function and stability. rnConclusion: Early intervention in the form of open reduction and internal fixation in cases of pilon fractures with large volar lip of base of middle phalanx restores the joint congruity and helps in achieving good functional outcome.