Large volar plate avulsion fracture of the base of the middle phalanx with rotational displacement: a report of three cases.

Three cases of large volar plate avulsion fracture at the base of the middle phalanx with significant displacement are reported. In each case, the fracture fragment involved about 30% of the articular surface and was rotated 90 degrees. The proximal interphalangeal (PIP) joint showed loss of volar stability with hyperextension stress. This unusual variant of volar plate injury is thought to be caused by subluxation of the PIP joint. All patients underwent open reduction and internal fixation. The fracture healed in anatomic alignment without articular incongruity or instability in all cases.