• Gavin Chun-Wui Kang, Andrew Yam, Ee San Phoon, Jonathan Yi-Liang Lee, and Lam-Chuan Teoh.
• Singapore General Hospital, Singapore.
• J Bone Joint Surg Am. 2012 Jun 6;94(11):e72.

BackgroundAvulsion fractures of the phalanges involve small osseous fragments that are usually attached to structures that are necessary for stability or movement of the joint. Satisfactory healing of the fracture to preserve joint function may require open reduction and internal fixation, which can be difficult because of the small size of the fragments.MethodsWe used a hook plate fashioned from a 1.3-mm Synthes titanium plate in thirteen patients with a phalangeal avulsion fracture. Four patients had an avulsion fracture of the volar plate with dorsal proximal interphalangeal joint dislocation, four had a dorsal avulsion fracture of the extensor central slip from the middle phalanx, three had a flexor digitorum profundus avulsion fracture from the distal phalanx, and two had an avulsion fracture of the phalangeal insertion of the collateral ligament.ResultsUnion without complications was achieved in all cases. After an average duration of follow-up of seventeen months, all patients had a good to excellent result and the average total interphalangeal motion was 149°.ConclusionsThis indirect fixation technique produces stable fixation allowing early active finger motion.

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