SH Type III Phalangeal Frx

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- Discussion: - most often occur in adolescents and pre-adolescents; - most often occurs in proximal phalanx due to anatomy of ligamentous insertions; - in middle phalanx, SH III frx arise from tendinous avulsions at insertion of the central slip or the volar plate; - Treatment: - volar avulsion: - immobilized in 30 deg of flexion; - dorsal avulsion frx: - w/ minimally displaced frx (less than 2mm displacement and less than 25% of joint surface), fracture can be immobilized in extension; - w/ displaced frx, consider ORIF w/ K wires;