Treatment of acute volar plate avulsion fracture by percutaneous pin fixation

Abstract

Objective To summarize the experience of treating acute volar plate avulsion fracture by percutaneous pin fixation, investigate its feasibility and effectiveness. and provide a reliable and effective treatment method for acute volar plate avulsion fractures. Methods From 2002 to 2007, 6 patients with acute volar plate avulsion fractures were treated surgically by percutaneous pin fixation under regional anesthesia. There were 4 men and 2 women with an average age of 26 years. Among them, 2 index fingers, 2 long fingers, 1 ring finger and 1 little finger were involved. The cause of the injury was sports injury in 4 cases, accident in 1 case, and forceful twisting in 1 case. Duration from injury to operation ranged from 1 to 8 days with an average of 3.5 days. Follow-up period ranged from 3 months to 5 years and 3 months, with an average of 1 year and 5 months. All 6 cases sustained avulsion fractures of middle phalanx base at the proximal interphalangeal (PIP) joint. Results All the patients achieved bone union at mean 6.8 weeks (range, 6 to 8 weeks) postoperatively. After rehabilitation PIP joint flexion reached 78° to 100° (average 83.5°) while PIP joint extension was 0° to -10°(average -6.5°). No static pain was found among those patients and they were all satisfied with their treatment outcome. Conclusion Percutaneous flexion blocking pin fixation was a reliable and effective treatment method for acute volar plate avulsion fractures. Key words: Fractures, bone; Fracture fixation, internal; Treatment outcome; Volar plate