Proximal phalanx, articular (head), unicondylar fracture with dislocation
These are rare unicondylar fractures that occur in the coronal plane and are associated with palmar, or dorsal, dislocations. If the PIP joint is dislocated dorsally, a coronal dorsal fracture is present. If the PIP joint is dislocated palmarly, a coronal palmar fracture is associated.
Typically these fractures are the results of sports injuries, occurring as a result of axial loading associated with hyperflexion or hyperextension. Condylar fractures tend to be very unstable and should usually be treated operatively, if the required skills and resources are available. If conservative treatment is attempted, secondary displacement leads to angulation of the finger.
Caveat These fractures are rare, but difficult to treat. There is an increased risk of joint stiffness resulting from these fractures. It is wise to use magnifying loupes in these procedures. Gentle and precise handling throughout the procedure is mandatory.