typically result in dorsal angulation (apex volar) because of the palmar
force of the intrinsic muscles on the proximal fragment and the dorsal
force of the extensor mechanism on the distal fragment. These are generally
unstable unless the force of the intrinsic muscles can be counteracted.
They are commonly treated either by reduction and percutaneous fixation
with longitudinal intramedullary Kirschner wires, open reduction with intraosseous
wires and Kirschner wires, or open reduction and fixation with mini plates
and screws (Fig. 5). In either
case, early motion of the proximal and distal interphalangeal joints is
needed to prevent stiffness.