Reverse Instrumentation for Headless Compression Screw Fixation of Basal Proximal Phalangeal Fractures.

Abstract

Intramedullary headless compression screw fixation of proximal phalangeal fractures permits semirigid stabilization through a minimally invasive approach with negligible tendon disturbance, allowing early mobilization and rehabilitation. Antegrade insertion is preferred for basal fractures, but various concerns and technical difficulties have been identified with both intra- and transarticular instrumentation. We describe a technical tip to facilitate easier guidewire insertion and instrumentation with a screw via an intra-articular approach.