Mini-anchor Versus Pull-out Suture for Surgical Management

Overview

Volar plate injuries of the joint are among the most common traumatic lesions in the hand. These injuries result from hyperextension trauma, leading to volar plate avulsion, often accompanied by collateral ligament injuries or fractures of the volar plate Conventional repair techniques include pull-out . Although widely used, pull-out sutures are associated with specific complications such as skin irritation. The external suture may also interfere with early mobilization, a key factor for good postoperative outcomes (3). Suture anchors have emerged as a modern alternative, offering internal fixation without the need for pull out sutures. Their application is believed to promote faster recovery, minimize soft tissue irritation, and early mobilization

Volar plate injuries of the joint are among the most common traumatic lesions in the hand. These injuries result from hyperextension trauma, leading to volar plate avulsion, often accompanied by collateral ligament injuries or fractures of the volar plate Conventional repair techniques include pull-out . Although widely used, pull-out sutures are associated with specific complications such as skin irritation. The external suture may also interfere with early mobilization, a key factor for good postoperative outcomes (3). Suture anchors have emerged as a modern alternative, offering internal fixation without the need for pull out sutures. Their application is believed to promote faster recovery, minimize soft tissue irritation, and early mobilization Aim of the Work The aim of this study is to compare the clinical and functional outcomes of mini-anchor versus pull-out suture techniques in surgical management of volar plate injuries of the PIP joint. -Place of the study: Sohag University Hospitals after approval from the institutional ethical committee. -Type of the study: A prospective randomized clinical trial. * Study period: From 1/10/2025 to 1/4/2026…………… \- Patients: This study will be conducted on patients with volar plate injuries of the PIP joint. An online randomization program (http://www.randomizer.org) will be used to generate a random list and each patients' code will be kept in an opaque sealed envelope. Patients will be randomly allocated with 1:1 allocation ratio into two groups in a parallel manner: * Group A: Patients will be managed using the modified pull-out suture technique. * Group B: Patients will undergo repair using mini suture anchors. \- Inclusion Criteria: * Patients aged 18-55 years. * Both sexes. * Isolated volar plate injury. * Closed injuries. * Injury duration \< 7 days. * Willingness to participate and follow rehabilitation protocol. \- Exclusion Criteria: * Osteoprotic patients * Associated neurovascular or tendon injuries. * Open fractures or infections. * Previous surgeries on the same finger. * Inability to follow up.