Volar plate arthroplasty of the distal interphalangeal joint

Ten patients with chronic dorsal fracture subluxation of the distal interph alangeal joint were managed over 5 years with volar plate advancement arthr oplasty. The mean time from injury to definitive surgical treatment was 8 w eeks (range, 2 weeks to 4 months). All injuries were characterized by volar comminution and impaction of the distal phalanx, with associated dorsal su bluxation. Surgical treatment included volar plate advancement arthroplasty and K-wire fixation of the reduced joint for 4 weeks. All patients were ev aluated at an average postoperative duration of 25 months (range, 10-60 mon ths). The average arc of motion of the distal interphalangeal joint of the 4 fingers (6) was 42 degrees and of the interphalangeal joint of the thumb (4) was 51 degrees. All patients had a residual flexion contracture averagi ng 12 degrees (range, 6 degrees to 25 degrees). Volar plate advancement art hroplasty is an effective treatment for chronic distal interphalangeal join t dorsal fracture subluxation. Copyright (C) 20012001 by the American Socie ty for Surgery of the Hand.