Mini Hook Plate Fixation for the Thumb Ulnar Collateral Ligament Fracture-Avulsion

Lee,  Sang yun; Woo,  Sang Hyun; Kang,  Ho Jung

doi:2019.24.2.142

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Original Article

Archives of Hand and Microsurgery 2019;24(2):142-151.
Published online June 1, 2019.
DOI: https://doi.org/10.12790/ahm.2019.24.2.142

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. kangho56@yuhs.ac

Received: 19 February 2019 • Revised: 28 April 2019 • Accepted: 1 May 2019

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.

Key Words: Thumb, Ulnar collateral ligament, Avulsion fractures, Hook plate fixation

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