Arch Hand Microsurg 2019; 24(2): 142-151  
Mini Hook Plate Fixation for the Thumb Ulnar Collateral Ligament Fracture-Avulsion
Sang-yun Lee1, Sang Hyun Woo1, Ho-Jung Kang2
1W Institute for Hand and Reconstructive Microsurgery, W General Hospital, Daegu, Korea
2Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea
Correspondence to: Ho-Jung Kang
Department of Orthopedic Surgery, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea
TEL: +82-2-2019-3412, FAX: +82-2-573-5393, E-mail: kangho56@yuhs.ac
Received: February 19, 2019; Revised: April 28, 2019; Accepted: May 1, 2019; Published online: June 1, 2019.
© Korean Society for Surgery of the Hand, Korean Society for Microsurgery, and Korean Society for Surgery of the Peripheral Nerve. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: Ulnar collateral ligament (UCL) avulsion fractures of thumb metacarpophalangeal joint (MCPJ) involve small bony fragments that are usually attached to structures that are necessary for stability or movement of the joint. Satisfactory reduction can be difficult because of the small size of the fragments. The aim of this article is to analyze outcomes of this technique.
Methods: We used a 1.2 mm titanium hook plate in seven patients with thumb UCL avulsion fracture of MCPJ, with a mean age of 33 years. The mean time from injury to operation was 13 days. Bone union was determined through radiographs. Clinical outcomes were evaluated by assessing range of motion (ROM) of the thumb MCPJ, pinch strength, grip strength, the visual analogue scale (VAS), and Korean version of the Michigan Hand Outcomes Questionnaire (K-MHQ) score.
Results: All patients achieved bone union within 3 months and mean follow-up period was 14.3 months. The postoperative ROM and VAS pain score improved. Grip and pinch strength were lower than the other hand but not statistically significant. No instability was observed. In addition, postoperative K-MHQ scores showed good results. One patient underwent hardware removal because of skin irritation and abnormal sensation. There were no other complications.
Conclusion: Mini hook plate fixation technique produced stable fixation and showed good clinical and radiologic outcomes in avulsion fracture of thumb MCPJ.
Keywords: Thumb, Ulnar collateral ligament, Avulsion fractures, Hook plate fixation


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