Figure Legend: Distal phalanx nonunions are uncommon, and usually follow open injuries. Risk factors include inadequate reduction of displaced fragments, soft tissue interposition or bone loss, including bone loss due to surgical debridement. The top image shows the type of acute displaced fracture which is best treated with internal fixation. The bottom image shows an established nonunion following bone debridement and wound closure. Most fractures which require bone debridement would benefit from internal fixation.  Late salvage of distal phalanx nonunions is technically demanding and requires precision bone grafting technique.
 

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