Articularly Placed Interfragmentary Screw Fixation of Difficult Condylar Fractures of the Hand

PurposeTo retrospectively review the outcomes of intra-articularly placed interfragmentary screws for fixation of difficult condylar fractures of the metacarpal and proximal phalangeal heads.MethodsWe placed interfragmentary screws intra-articularly in 10 patients with 11 fractures to achieve a rigid fixation construct in which the non-articular portion of the bone fragment is too small to allow a stable fixation, or where the bone fragment is entirely osteochondral.ResultsThe mean duration of follow-up was 15.9 months (range, 6–45 mo). All fractures united within 16 weeks (average, 8.1 wk). We observed subsidence in 1 case; another patient had screw protrusion that required removal. The range of motion of the involved metacarpophalangeal joints for the metacarpal head fractures was 79° (range, 60° to 90°). The range of motion of the involved proximal interphalangeal joints for the proximal phalangeal head fractures was 86° (range, 80° to 90°).ConclusionsIntra-articularly placed interfragmentary screw fixation is a good technique for treating difficult condylar fractures of the hand.Type Of Study/Level Of EvidenceTherapeutic IV.