Internal fixation of an unstable open fracture of a distal phalanx with a Herbert screw.

A 20-year-old patient was seen with an unstable, infected, open fracture of the distal phalanx of the long finger of the right dominant hand. The patient was treated by removal of the nail, debridement of the fracture site, and stabilization of the fracture with a Herbert screw. The Herbert screw compressed the fracture site and allowed early active motion of the distal inter-phalangeal (DIP) joint. The wound healed without incident, and the fracture was radiographically united 6 weeks after the procedure. The Herbert screw is useful in the treatment of unstable fractures of the distal phalanx, since the screw maintains reduction, compresses the fracture site, and allows early active motion of the DIP joint.