To evaluate the clinical and radiological results of operative treatment for dorsal lip fracture of the base of the middle phalanx.

From 1992 to 2003 we experienced 9 cases of dorsal lip fracture of the middle phalangeal base that were treated surgically. Spinal needle fixation was used in cases with comminution. iniscrew fixation was performed in cases with a fragment larger than half of the articular surface. The pull-out technique was performed only in the cases with a fragment without comminution smaller than half of the articular surface. Bone union was evaluated using roentgenograms and clinical evaluations were done using Steel's scoring method.

The average follow up after operation was 12.3 months. Cases showed union at an average of 7 weeks postoperatively. Two cases achieved excellent results, six cases good, and one case achieved a fair result; mean proximal interphalangeal joint flexion was 100 ° (range 90-106). Extension deficit of 5 ° was noted in 2 fingers.

The pull-out technique, miniscrew fixation, and spinal needle fixation can produce a good clinical and radiological outcome in the treatment of dorsal lip fracture of the base of the middle phalanx.