Percutaneous pinning of middle phalangeal neck fractures: surgical technique.

Extra-articular middle phalangeal neck fractures are uncommon fractures of the hand that are often difficult to treat. Surgery is indicated when closed reduction fails; 1 option is closed reduction and percutaneous pinning. Maintaining closed reduction while inserting K-wires is challenging. We present a new technique for percutaneous pinning of these fractures that was developed to address these issues. Our technique uses flexion of the interphalangeal joints during K-wire insertion to maintain fracture reduction and improve fixation.