This study evaluates the clinical efficacy of dual bone tunnel reconstruction for treating volar plate avulsion injuries in proximal interphalangeal （PIP） joints of the finger.

A retrospective analysis was conducted on 7 patients with the proximal interphalangeal joint volar plate avulsion injuries，who were treated at the Department of Hand Surgery，Suzhou Ruihua Orthopaedic Hospital between June 2021 and January 2024. The cohort included 5 males and 2 females，aged 22–63 （46.0±15.7） years. Injury distribution： 1 left hand，6 right hands； 1 index finger，2 middle fingers，1 ring finger，and 3 little fingers. Mechanisms of injury comprised falls （n=2），machinery entanglement （n=3），vehicular accidents （n=1），and crush injuries （n=1）. All cases of avulsion injuries involved dorsal dislocation of the proximal interphalangeal joints，including 3 cases with Type Ⅱ avulsion fractures of the middle phalanx base and 4 non-fracture cases. Emergency surgical intervention via volar approach was performed： fragmented bone was debrided with cortical preservation，followed by anatomic reattachment of the avulsed volar plate using dual bone tunnels with nonabsorbable sutures.

Primary wound healing was achieved in all cases. Mean follow-up duration was 6 months （range： 4–10 months）. At final assessment，active PIP joint flexion ranged from 70 ° to 100 ° with stable joints and absence of pain during motion. According to the upper limb function assessment of the Chinese Medical Association Hand Surgery Society，outcomes were graded as excellent in 3 cases and good in 4 cases.

Dual bone tunnel reconstruction provides a technically feasible and clinically effective solution for PIP joint volar plate avulsion injuries，demonstrating satisfactory functional restoration.