Clinical outcomes after mini-hook plate fixation for small avulsion fractures around the interphalangeal or metacarpophalangeal joints of the hand

Abstract

Background Mini-hook plate has been described for the treatment of various small avulsion fragments in the hand. This retrospective study aimed to evaluate clinical outcomes after mini-hook plate fixation in patients with an avulsion fracture around the interphalangeal or metacarpophalangeal joints of the hand. Methods Nineteen patients with avulsion fractures around the interphalangeal or metacarpophalangeal joints of the hand were included in this study. Seven patients had a mallet fracture, and 12 patients had other phalangeal avulsion fractures including central slip, collateral ligament, volar plate, and flexor avulsion fractures. The osseous union and functional outcomes, including finger joint motion, joint stability, pinching strength, and the disabilities of the arm, shoulder, and hand score, were evaluated. Results The mean duration of follow-up was 33.8 months. All patients in mallet and other phalangeal avulsion fractures achieved osseous union between the avulsion fragment and phalangeal bone, and there was no joint subluxation. There were no significant differences in the disabilities of the arm, shoulder, and hand scores. However, the patients with mallet fracture have lower mean percentage values of the total active range of motion and pinching strength than other phalangeal avulsion fractures. We abandoned this procedure in mallet fractures because the early results after mini-hook plate fixation in mallet fractures appeared unfavorable. Conclusion These results suggest that the mini-hook plate fixation can provide sufficient stability and good clinical outcomes in those with phalangeal avulsion fractures. However, the outcomes for mallet fractures were not as good as those for other phalangeal avulsion fractures.

The biomechanical properties of the hook plate and pull-out suture in mallet finger fractures: a cadaveric study

“…Hook plate fixation (Teoh and Lee, 2007;Theivendran et al, 2007) has advantages in terms of allowing anatomical reduction, rigid internal fixation, early joint mobilization and avoids pin exposure, which is clearly advantageous for postoperative care. Previous studies (Acar et al, 2015;Lee et al, 2021;Tie et al, 2017;Wang et al, 2021) have reported good to excellent surgical outcomes with DIP flexion of 60 , extension lag 0 as well as good functional scores.…”

“…To date, all rehabilitation protocols have proposed a period of immobilization after surgery. Regimes include immobilization in full extension for 1 week and then allowing mobilization (Acar et al., 2015), 2 weeks of full-time extension immobilization and then passive ROM (Lee et al., 2021; Wang et al., 2021), or full-time splintage for 3 weeks and then active ROM (Tie et al., 2017). The results of our biomechanical studies indicate that it is possible to allow the patient to mobilize the injured finger immediately after surgery using either of the two techniques with an appropriate rehabilitation protocol.…”

Outcome Following Acute Suture Anchor Repair of the Ulnar Collateral Ligament of the Thumb

“…2,4,8,9 Various techniques exist for bony reattachment of the thumb UCL, including pullout suture, 4,5 tension-band wiring 10 and mini-hook plate fixation. 11 The use of suture anchors for thumb UCL repair was first documented thirty years ago, 12 and suture anchor repair has since increased in popularity due to its favourable biomechanical properties, 13 low complication rate 9 (particularly compared with pullout suture 14 ) and the positive clinical outcomes associated with the technique. 8 However, studies reporting outcomes following suture anchor repair are heterogeneous, involving a range of anatomical sites outwith the thumb, 15 a mix of acute and chronic injuries 6,16,17 and the use of supplementary transarticular K-wiring 18 or suture tape augmentation.…”