Volar A1 pulley approach for fixation of avulsion fractures of the base of the proximal phalanx

K. M. Kuhn, K. D. Dao, A. Y. Shin

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Avulsion fractures of the base of the proximal phalanx associated with collateral ligament instability, excluding the thumb, are relatively rare. While the indications for surgical intervention vary, dorsal approaches have been advocated despite the volar location of the fracture fragment and orientation of the collateral ligaments. Ten patients with 11 avulsion fractures at the base of the proximal phalanx associated with collateral ligament instability were treated with open reduction and internal fixation using a volar A1 pulley approach. Anatomic restoration of the articular surface and collateral ligament stability were obtained in all patients. All fractures healed between 5 and 9 weeks (average, 6 weeks). After an average 19.4-month follow-up period all patients had full range of motion of the metacarpophalangeal joint, collateral ligament stability, and grip strength of at least 90% of the uninjured hand. No perioperative complications occurred. The average DASH score at last follow-up examination was 1.8 (range, 0-6). All patients were satisfied with the outcome of surgery. The volar A1 pulley approach is a direct and effective approach for reduction and fixation of avulsion fractures of the base of the proximal phalanx associated with collateral ligament instability.

Original languageEnglish (US)
Pages (from-to)762-771
Number of pages10
JournalJournal of Hand Surgery
Volume26
Issue number4
DOIs
StatePublished - Jan 1 2001

Keywords

  • Avulsion fracture
  • Outcome
  • Proximal phalanx
  • Volar approach

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Fingerprint Dive into the research topics of 'Volar A1 pulley approach for fixation of avulsion fractures of the base of the proximal phalanx'. Together they form a unique fingerprint.

  • Cite this