The utility of locking plate fixation combined with intraosseous wiring for an intra-articular depressed fracture of the middle phalangeal base: A case report

Comminuted depressed fractures at the base of the middle phalanx are often difficult to treat with a single fixation method, as achieving both anatomic reduction and stable fixation can be challenging. While soft stainless steel wire fixation and locking plate fixation have each been used individually as definitive treatments, no reports to date have described a combined approach. We present the case of a 74-year-old man with comminuted depressed fractures at the base of the middle and ring finger middle phalanges, successfully treated using a locking plate in combination with soft stainless steel wire. The addition of the wire allowed for temporary stabilization of fracture fragments, prevented displacement during screw insertion, and improved overall construct stability. This technique also enabled early postoperative rehabilitation to reduce the risk of adhesion. The combined use of soft stainless steel wire and locking plate fixation may represent a useful strategy for managing complex fractures of the middle phalanx base.