Late volar plate repair for chronic, post-traumatic hyperextension deformity of the proximal interphalangeal joint of the little finger

Abstract

A chronic traumatic hyperextension of the proximal interphalangeal (PIP) joint can result from traumatic volar plate (VP) disruption. For the treatment of this disorder, reconstruction procedures have been traditionally recommended, because the condition of the VP was not considered susceptible to repair due to retraction or attenuation. The purpose of this paper is to present the operative technique and report the clinical results of late VP repair. Late VP repair was performed for chronic, post-traumatic hyperextension deformity of the PIP joint of the little finger resulting from VP disruption in seven consecutive patients. The range of motion and the lateral stability of the PIP joint were evaluated. The radiographic images were also used to evaluate the alignment and degenerative changes of the PIP joint. Clinical results were classified according to Catalano’s criteria. Intraoperative findings showed that the VP could be mobilised and repaired in all cases. The hyperextension was well corrected, and none showed recurrence of the initial deformity. Average flexion of the PIP joint was 92° (range = 75–98°), and flexion contracture was 9° (range = 0–20°). On clinical evaluation, there were two excellent, three good, and two fair results. The postoperative radiographs revealed no degenerative change in the PIP joint in six patients. Late VP repair is a successful and reliable alternative and more physiologic than other reconstruction methods. One should first consider late VP repair, despite a long interval between injury and repair.

Key Words:

• proximal interphalangeal joint
• hyperextension deformity
• volar plate
• little finger.

Acknowledgement

The part of this report was reported as “Repair of chronic traumatic volar plate insufficiency of the proximal interphalangeal joint of the little finger”. in J Jpn Soc Surg Hand 2008;25:48–53. Japanese (reference #4).

Declaration of Interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.