Mini-anchor Versus Pull-out Suture for Surgical Management

A Brunner volar incision will be made, and the volar plate avulsion fragment will be identified. A 2-0 nonabsorbable braided suture will be passed through the volar plate using Kessler pattern, and Keith needles will be used to exit the sutures dorsally . .

Using the same volar approach, the volar plate will be reattached with two Mitek Micro QuickAnchors (1.3 x 3.7 mm), placed at the distal phalanx. Anchors will be inserted under fluoroscopic guidance to avoid dorsal cortex penetration. A hemimodified Kessler stitch pattern will be used with 3-0 polyester sutures.