Hook plate fixation for volar plate avulsion fractures of the middle phalanges in Korea: a case series

Background: Volar plate avulsion fractures in phalanges are relatively common injuries. While surgical treatment can help reduce limitations in motion after injury, the small size of the fracture fragment can make the procedure challenging. In this study, we used hook plate fixation as a surgical technique for treating volar avulsion fractures in phalanges and evaluated its radiological and clinical outcomes.Methods: The medical records of eight patients (nine digits) with volar plate avulsion fractures of the middle phalanx were retrospectively reviewed. All fractures were treated with a 1.5-mm hook plate after open reduction. Radiologic evaluations were performed using simple radiographs, and clinical outcomes were assessed through range of motion, instability, and pain.Results: The mean follow-up period was 4.89 months (range, 1–9 months). All nine digits achieved bone union at the final follow-up. The mean union time was 2.2 months (range, 1–4 months). In all patients, the range of motion in the proximal interphalangeal joint was 85° (range, 70°–100°) before implant removal and 89.4° (range, 80°–100°) after implant removal. All patients demonstrated no joint instability and no residual pain.Conclusion: Using a hook plate for volar plate avulsion fractures presents a promising alternative to existing fixation methods. Its biomechanical advantages and ease of fabrication make it a valuable tool in hand surgery.Level of evidence: IV.