There are several fixations used to treat avulsion fractures, mainly including screw fixation, percutaneous Kirschner wire (K-wire) fixation, bone grafting, and plating fixation. The conservative treatment often has a poor therapeutic effect on avulsion fractures around joints, easily leading to fracture nonunion, joint instability and joint adhesion. Most avulsion fractures were intra-articular fractures, while relatively small fracture fragments are commonly attached to the ligament and capsule, making the joint difficult to return to the normal anatomical position. As reported, the contractile properties of muscle and the attachment of tendons and ligaments at both ends of bone collectively contributed to the muscle contraction, so unexpected contraction of the muscles could lead to avulsion fractures at the site of tendon or ligament attachment. Avulsion fractures occur when the capsule, ligaments or tendons are avulsed from the bone due to unexpected contraction of the muscles or mechanical force. Joints are surrounded by articular capsule, ligaments and tendons. Hook plate fixation has the therapeutic effect on treating avulsion fractures around joints of extremities with the advantages of reliable fixation, early rehabilitation after operation, high recovery rates of joint function, wide indications, and convenient uses. In the last follow-ups, the functional score of the affected limb was markedly greater than that in the 3-month follow-ups ( p < 0.05). Three patients with humeral avulsion fracture of the greater tuberosity had shoulder joint adhesion and peri humeral inflammation at the last follow-up due to the poor cooperation for early rehabilitation exercise. A total of 57 patients were well recovered with the excellent and good rate of 95%. At the last follow-up, no instability of joints, looseness of internal fixation or traumatic arthritis was observed. The average follow-up period was 18.1 months. ResultsĪll the patients were healed within 3 months after surgery with stage I healing incision without vascular or nerve injuries. Functional recovery was evaluated using the Lysholm knee score, Kaikkonen ankle injury score, Mayo elbow and wrist function score, and Neer shoulder function score. MethodsĪ total of 60 patients with avulsion fractures of joints admitted in our hospital between January 2011 and June 2016 were performed the surgery of hook plate fixation. This study proposed to access the clinical outcome of avulsion fractures around joints of extremities using the hook plate.
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