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1Principles

Avulsion fractures of the volar plate are very common injuries, often resulting from sporting injuries and usually involving ...

Classification of avulsion fractures of the volar plate

Avulsion fractures of the volar plate are very common injuries, often resulting from sporting injuries and usually involving the middle and ring fingers. Several classification systems for them have been proposed. The Eaton classification is very useful for practical purposes. This classification is based on the premise that successful treatment must be based on the stability of the fracture, which in turn depends on:

  • size of the fragment
  • degree of impaction,
  • presence of one or both collateral ligament ruptures
  • direction of the dislocation (hyperextension, lateral dislocation, flexion).

 

Eaton type I (hyperextension)
These are hyperextension injuries, with an avulsion of the volar plate without fracture, and a longitudinal split in the collateral ligaments.

Eaton type II (dorsal dislocation)
Complete dorsal dislocation of the PIP joint and volar plate avulsion without fracture. The base of the middle phalanx rests dorsally on the condyles of the proximal phalanx, with no contact between the articular surfaces.