The hook plate technique for fixation of phalangeal avulsion fractures.
BACKGROUND
Avulsion fractures of the phalanges involve small osseous fragments that are usually attached to structures that are necessary for stability or movement of the joint. Satisfactory healing of the fracture to preserve joint function may require open reduction and internal fixation, which can be difficult because of the small size of the fragments.


METHODS
We used a hook plate fashioned from a 1.3-mm Synthes titanium plate in thirteen patients with a phalangeal avulsion fracture. Four patients had an avulsion fracture of the volar plate with dorsal proximal interphalangeal joint dislocation, four had a dorsal avulsion fracture of the extensor central slip from the middle phalanx, three had a flexor digitorum profundus avulsion fracture from the distal phalanx, and two had an avulsion fracture of the phalangeal insertion of the collateral ligament.


RESULTS
Union without complications was achieved in all cases. After an average duration of follow-up of seventeen months, all patients had a good to excellent result and the average total interphalangeal motion was 149°.


CONCLUSIONS
This indirect fixation technique produces stable fixation allowing early active finger motion.
Singapore General Hospital, Singapore.
Gavin Chun-Wui
GC
Kang
Andrew
A
Yam
Ee San
ES
Phoon
Jonathan Yi-Liang
JY
Lee
Lam-Chuan
LC
Teoh
D000328:Adult; D001860:Bone Plates; D015331:Cohort Studies; D005260:Female; D005383:Finger Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D050278:Finger Phalanges / Q000000981:diagnostic imaging / Q000293:injuries*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology; D012189:Retrospective Studies; D018570:Risk Assessment; D014025:Titanium; D055815:Young Adult
D014025:Titanium