Eight displaced central slip attachment fractures were treated by open reduction and internal fixation to avoid boutonniere deformity, to reduce the fracture anatomically and to allow early mobilization of the joint. This injury should be recognized as a disruption of the dynamic extensor mechanism associated with an intraarticular fracture, fracture-dislocation or soft tissue injury of the PIP joint. We have grouped central slip attachment fractures into three types according to the mechanism of injury, with suggested methods of treatment.