Keifhaber-Stern classification of volar plate avulsion injuries of hand
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The Keifhaber-Stern classification was proposed originally by Hastings and later modified by Keifhaber and Stern in 1998. This classification, along with the Eaton classification, is the most widely accepted classification at the time of writing (August 2016) for the management of volar plate avulsion injuries of the PIP joint 1.
According to this classification, there are three types of volar plate avulsion injury:
- stable avulsion fracture involving <30% of the articular base of the middle phalanx
- tenuous avulsion fracture involving 30%-50% of the articular base of the middle phalanx; reduces with <30° of flexion
- unstable avulsion fracture involving <50% articular base of the middle phalanx but requires >30° flexion to maintain reduction