Eighteen patients with industrial injuries to the dorsum of the proximal interphalangeal joint involving articular destruction and segmental bone loss were treated by primary bone grafting and plating. Rigid arthrodesis and preservation of functional length were obtained in 25 fingers. Of the 25 fingers, 23 fused primarily. Because of technical error, one reconstruction showed delayed consolidation and required secondary grafting before uniting; one arthrodesis became infected and healed by second intention. Additional procedures were flexor tendon repair, nerve grafting, and local or distant flap coverage. The procedure is considered valid for the treatment of extensive skeletal damage to the proximal interphalangeal joint area.