Arch Plast Surg.  2018 Sep;45(5):458-465. 10.5999/aps.2018.00346.

Volar plate avulsion fracture alone or concomitant with collateral ligament rupture of the proximal interphalangeal joint: A comparison of surgical outcomes

• Kim YW
• Roh SY
• Kim JS
• Lee DC
• Lee KJ

• KMID: 2422142
• DOI: http://doi.org/10.5999/aps.2018.00346

Abstract

BACKGROUND
Volar plate avulsion fracture of the proximal interphalangeal (PIP) joint is one of the most common hand injuries. In this study, we divided patients into two groups: patients with pure volar plate avulsion fracture, and patients with volar plate avulsion fracture concomitant with collateral ligament rupture. The purpose of this study was to compare long-term surgical outcomes between the two groups. As a secondary measure, the Mitek bone anchoring and polydioxanone (PDS) bone suturing techniques were compared.
METHODS
A single-institutional retrospective review of the surgical treatment of volar plate avulsion fracture was performed. The cases were divided into those with pure volar plate avulsion fracture (group A, n=15) and those with volar plate avulsion fracture concomitant with collateral ligament rupture (group B, n=15). Both groups underwent volar plate reattachment using Mitek bone anchoring or PDS bone suturing followed by 2 weeks of immobilization in a dorsal protective splint.
RESULTS
The average range of motion of the PIP joint and extension lag were significantly more favorable in group A (P < 0.05). Differences in age; follow-up period; flexion function; visual analog scale scores; disabilities of the arm, shoulder, and hand scores; and the grip strength ratio between the two groups were non-significant. No significant differences were found in the surgical outcomes of Mitek bone anchoring and PDS bone suturing in group A.
CONCLUSIONS
Overall, the surgical outcomes of volar plate reattachment were successful irrespective of whether the collateral ligaments were torn. However, greater extension lag was observed in cases of collateral ligament injury.

Keyword

Finger joint; Joint dislocations; Fractures, avulsion; Suture anchors; Range of motion, articular

MeSH Terms

Arm
Collateral Ligaments*
Finger Joint
Follow-Up Studies
Hand
Hand Injuries
Hand Strength
Humans
Immobilization
Joints*
Polydioxanone
Range of Motion, Articular
Retrospective Studies
Rupture*
Shoulder
Splints
Suture Anchors
Visual Analog Scale
Polydioxanone