The management of unstable PIP joint fracture-dislocations can be quite challenging and frustrating. For those injuries with more than 40% involvement of the volar middle phalangeal base, closed reduction is usually not sustainable, and surgery is required. Many surgical techniques have been described, ranging from simple pinning of the joint to open reduction and internal fixation, and external fixation. However, thus far, no technique has shown superiority over the others. This guide describes a relatively simple technique to both control the tendency to dorsal subluxation and to reduce the articular surface.Quick Tips