A, Persistent dorsal proximal interphalangeal joint subluxation with nonreconstructible middle phalangeal volar lip fracture. B, Volar exposure of middle phalangeal base and geometrical preparation of defect for graft. C, Fluoroscopic view of distal hamate donor site. D, Fixation of graft with two minifragment screws to replicate middle phalangeal base concavity. E, Concentric joint without collapse or dorsal subluxation at 2 years after surgery. SEE TECHNIQUE 67.20.