Dear Sir, Avulsion fracture of the collateral ligament at the base of the proximal phalanx is occasionally seen and the avulsed fragment may rarely involve a significant segment of the articular surface which can lead to joint incongruity. Inadequate reduction and fixation of this fracture can cause instability, persistent pain, and result in osteoarthrosis. These avulsion fracture have been treated with pull-through sutures, wire-loop fixation, tension band wiring, K-wiring and intra-fragmentary screws (Bischoff et al., 1994; Sakuma et al, 1997; Shewring and Thomas, 2003). A closed reduction and fixation technique (Ishiguro et al., 1997) was described for mallet finger fracture. We used this method to treat the avulsion fracture of the base of the proximal phalanx from 2004 in five avulsion fractures in four patients. Two males (three fingers) and two females (two fingers) were treated. Their mean age was 21 years (range, 11-57 years). All occurred in the left hand due to a fall and avulsed the radial side of the proximal phalanx of the ring (2) and little (3) fingers. These fractures involved 1/4 ~ 1/3 of the joint surface. The mean preoperative period was three days (range, 1-8 days).
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