Abstract
We present our experience with 14 volar plate avulsion fractures of the fingers that were treated by excision or internal fixation and discuss the factors affecting the operative techniques and results. Fourteen cases were divided into two groups: the volar plate avulsions with excision (eight cases) and the volar plate avulsions with fixation (six). We compared clinical factors between fracture groups and between fixation methods. Fractures treated with fixation had the larger fragment, a shorter preoperative period, and the larger articular surface involvement than fractures treated with excision. Postoperative pain, average age, patients’ satisfaction measured by VAS, DASH scores, grip, and pinch strength were not different between two groups. All fixated fractures healed and the time to union did not differ based on fixation method. The true size of the fracture fragment was larger than expected based on the X-ray and the fragments were usually rotated by pull of the volar plate or ligament. The size and shape of the avulsed fragment might be important factors to determine the treatment method, but the results after operation were not significantly different whether the fragment was excised or fixed.
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Aladin A, Davis TR (2005) Dorsal fracture-dislocation of the proximal interphalangeal joint: a comparative study of percutaneous Kirschner wire fixation versus open reduction and internal fixation. J Hand Surg Br 30(2):120–128
Bekler H, Gokce A, Beyzadeoglu T (2006) Avulsion fractures from the base of phalanges of the fingers. Tech Hand Up Extrem Surg 10(3):157–161
Cheah AE, Tan DM, Chong AK, Chew WY (2012) Volar plating for unstable proximal interphalangeal joint dorsal fracture-dislocations. J Hand Surg Am 37(1):28–33
Chew WY, Cheah AE (2010) Volar plate and screw fixation for dorsal fracture-dislocation of the proximal interphalangeal joint: case report. J Hand Surg Am 35(6):928–930
Gaine WJ, Beardsmore J, Fahmy N (1998) Early active mobilisation of volar plate avulsion fractures. Injury 29(8):589–591
Grant I, Berger AC, Tham SK (2005) Internal fixation of unstable fracture dislocations of the proximal interphalangeal joint. J Hand Surg Br 30(5):492–498
Hamilton SC, Stern PJ, Fassler PR, Kiefhaber TR (2006) Mini-screw fixation for the treatment of proximal interphalangeal joint dorsal fracture-dislocations. J Hand Surg Am 31(8):1349–1354
Itadera E, Muramatsu Y, Shibayama M, Oikawa Y, Moriya H (2010) Trans-web approach for fixation of avulsion fractures of the proximal phalangeal base: report of two cases. J Hand Surg Am 35(3):412–414
Komura S, Yokoi T, Nonomura H (2011) Mini hook plate fixation for palmar fracture-dislocation of the proximal interphalangeal joint. Arch Orthop Trauma Surg 131(4):563–566
Lee JY, Teoh LC (2006) Dorsal fracture dislocations of the proximal interphalangeal joint treated by open reduction and interfragmentary screw fixation: indications, approaches and results. J Hand Surg Br 31(2):138–146
Mikami Y, Takata H, Oishi Y (2011) Kirschner wire stabilization of collateral ligament avulsion fractures of the base of the proximal phalanx. J Hand Surg Eur 36(1):78–79
Sakuma M, Nakamura R, Inoue G, Horii E (1997) Avulsion fracture of the metacarpophalangeal joint of the finger. J Hand Surg Br 22(5):667–671
Sawant N, Kulikov Y, Giddins GE (2007) Outcome following conservative treatment of metacarpophalangeal collateral ligament avulsion fractures of the finger. J Hand Surg Eur 32(1):102–104
Shewring DJ, Thomas RH (2003) Avulsion fractures from the base of the proximal phalanges of the fingers. J Hand Surg Br 28(1):10–14
Shewring DJ, Thomas RH (2006) Collateral ligament avulsion fractures from the heads of the metacarpals of the fingers. J Hand Surg Br 31(5):537–541
Takami H, Takahashi S, Ando M (1997) Large volar plate avulsion fracture of the base of the middle phalanx with rotational displacement: a report of three cases. J Hand Surg Am 22(4):592–595
Waris E, Alanen V (2010) Percutaneous, intramedullary fracture reduction and extension block pinning for dorsal proximal interphalangeal fracture-dislocations. J Hand Surg Am 35(12):2046–2052
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This work was supported by the 2012 Inje University research grant.
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Lee, S., Jung, E.Y. & Kim, J.Y. Operative treatment for volar plate avulsion fractures of the fingers. Arch Orthop Trauma Surg 133, 1463–1467 (2013). https://doi.org/10.1007/s00402-013-1818-2
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DOI: https://doi.org/10.1007/s00402-013-1818-2