INTRODUCTION: Fractures of the base of the middle phalanx of the hand include the entire spectrum of injuries. They can be divided into fractures of the volar part of the base of the phalanx at the place where the metacarpophalangeal volar plate is attached, fractures of the dorsal part of the base of the phalanx at the insertion point of the central extensor band, or complex fractures of the pilon. The paper presents case reports that point to possible errors in diagnosis and treatment. Furthermore, an overview of current therapeutical concepts is presented. DISCUSSION: The treatment method is based on the evaluation of the stability of the proximal interphalangeal joint. Stable injuries are treated conservatively, unstable fractures require surgical treatment. For conservative treatment, functional therapy is preferred. Possibilities of treatment of unstable injuries include open reduction and osteosynthesis, closed reduction and stabilization by dynamic external fixation, or more advanced methods of reconstruction, such as volar plate arthroplasty and hemi-hamate arthroplasty. CONCLUSION: Quality diagnostics, surgeon‘s erudition and material equipment are essential for successful treatment. Despite proper treatment, full functional recovery is usually not achieved. The aim of therapy is the patient´s functional and painless finger.

Department of Orthopaedics and traumatology Prostějov Hospital

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