Proximal interphalangeal joint volar plate interposition arthroplasty. A, Through proximal interphalangeal joint volar approach, volar plate is detached from middle phalangeal base. Two holes are drilled perpendicular to middle phalangeal base for passing sutures. B, Sutures are attached to volar plate and drawn dorsal to volar through bone tunnels and tied on the volar side of middle phalangeal base. C, A 1-mm Kirschner wire is used to fix joint in 20 degrees of flexion.