Bicondylar Fractures of the Proximal Phalanx

Bicondylar fractures of the proximal phalanx are approached dorsally by incising between the extensor slip and the lateral band on either side of the fracture. Alternatively, osteotomy of the dorsal lip of the proximal portion of the middle phalanx can be performed, and the insertion ofthe central slip can be reflected proximally by dissecting on either side of it, providing excellent visualization of the joint surfaces. A screw hole should be predrilled before the osteotomy so that the dorsal lip can be secured at the end of the procedure.