Volar Plate Repair for Chronic Injury.

PURPOSE: The aim of this study was to assess the long-term outcomes of volar plate repair for chronic injury.

METHODS

Patients who underwent volar plate repair for chronic instability more than 6 months following the initial injury were included. A minimum follow-up of 2 years from time of surgery was required. Outcome measures included range of motion, the upper extremity QuickDASH (Disabilities of the Arm, Shoulder, and Hand) score, return to work, return to sport, and plain radiographs.

RESULTS

Ten patients were included. The mean time from injury to repair was 9 years, ranging from 10 months to 30 years. The digits involved included one thumb, four ring fingers, and five small fingers. Nine reported being extremely satisfied, and one reported being satisfied with their outcome at final follow-up. Nine of ten reported pain as their initial symptom, and none reported pain at final follow-up. Prior to surgery, all patients had proximal interphalangeal hyperextension ranging from 15° to 60°, three of which were classified as swan neck deformities. At final follow-up, nine patients had extension ranging from 0° to 3°. In addition, one patient had a hyperextension of 25°, although this patient had a subsequent injury. All had full flexion of their proximal interphalangeal joint at final follow-up. The three subjects who reported occupational impairment prior to surgery had no functional limitations following surgery. Two subjects whose injuries led to sport limitations reported returning to their preinjury level of sport.

CONCLUSIONS

Volar plate repair for chronic injury resulted in successful outcomes based on satisfaction, QuickDASH score, physical examination, and radiographic images. These benefits were noted in a repairs performed decades after injury.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.