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We use it in type IV lesions according to the modified Tubiana classification (A). Under fluoroscopy the distal interphalangeal joint (DIPJ) is flexed (B), and a first K-wire is pinned through the extensor tendon into the middle phalanx. The wire is used as a lever that pushes on the bony fragment once the DIPJ is extended (C). A second K-wire is put across the DIPJ to avoid flexion (D).
