Surgical treatment of volar plate avulsion fractures of the proximal interphalangeal joint with suture anchors

BACKGROUND: To compare clinical and radiographic outcome of early and delayed surgical treatment of traumatic avulsion of the volar plate at the base of P2 of the fingers of the hand by bony fragment excision and reinsertion of the volar plate with suture anchor.METHODS: We retrospectively analyzed 26 cases of volar plate avulsion injuries of PIP joint surgically treated: 10 pa-tients underwent surgery immediately after trauma (early surgery group), and 16 beyond 30 days (delayed surgery group). Clinical outcome was evaluated using Quick-DASH Score, VAS, range of motion expressed as loss of motion (LOM) and strength measured with the tip-pinch test. Radiographic evaluation was performed to assess maintenance of reduction and complications such as signs of late osteoarthritis or intra-articular calcifications.RESULTS: LOM was significantly more severe in the delayed surgery group, both preoperatively and at follow-up. No significant differences were found between groups for Quick-DASH Score, VAS, stability, strength and late complica-tions and maintenance of reduction.CONCLUSIONS: Excision of the bony fragment from the base of P2 and use of a suture anchor for the bony reattach-ment of the volar plate demonstrated good clinical and radiographic results, with no risk of postoperative instability. Acute treatment reduced the risk of joint stiffness and provided better ROM of PIP joint than delayed surgery. Timing did not affect subjective outcome, strength, and occurrence of late sequelae.