The Versatile Hook Plate in Avulsion Fractures of the Hand

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Traumatology

Background:

• Avulsion fractures in the hand present surgical fixation challenges due to small fragment size and difficult access.
• Traditional treatments like K-wires, screws, and sutures have limitations for these specific injuries.

Purpose of the Study:

• To describe the technique of fabricating and utilizing hook plates for avulsion fractures in the hand.
• To evaluate the efficacy and versatility of hook plates in treating various hand avulsion fractures.

Main Methods:

• A retrospective review of 63 hand fracture cases treated with hook plates between 2008 and 2014.
• Cases included mallet fractures, proximal interphalangeal joint fracture dislocations, flexor digitorum profundus avulsions, central slip avulsions, and collateral ligament avulsions.

Main Results:

• All fractures demonstrated successful healing with no biomechanical failures and achieved good functional outcomes.
• Plate removal was necessary in 25 cases (primarily mallet fractures), and 13% experienced complications, mostly related to mallet fractures.

Conclusions:

• Hook plates are a simple, easily fabricated device with a biomechanical advantage for fixing small avulsion fractures in the hand.
• This technique is versatile, reduces the risk of fragment displacement, and can achieve joint congruence when performed meticulously.