Volar Plate Finger Injuries

Volar plate injuries - SIM Physiotherapy Frenchs Forest and Macquarie Park

What is the volar plate and how is it injured?

The volar plate is a fibrocartilaginous structure (ligament) on the palmar aspect of the joint. It connects two bones together and prevents separation.


Causes of volar plate injuries:

Volar plate injuries occur when the finger bends backward too far (hyperextended).


Signs and symptoms of volar plate injuries:

  • Reduced pinch strength

  • Pain and swelling over the middle joint of the finger

  • Reduced range of motion of the proximal interphalangeal joint

  • Laxity/looseness of the volar plate on stress testing

  • Possible small avulsion fracture may be seen on x-ray

What is the treatment of a volar plate injury?

Splinting for volar plate injuries - SIM Physiotherapy Frenchs Forest and Macquarie Park

Treatment for volar plate injuries of the PIPJ varies depending on the severity of the injury. Conservative management may be sufficient for stable injuries, involving splinting the injured finger in slight flexion for approximately 1-3 weeks to allow for healing while preventing hyperextension. The finger will remain in the splint for a total of 4-6 weeks depending on the severity, pain, range of motion and laxity of the ligament. Patients will often return to sport between 4-8 weeks.

Complications associated with volar plate injuries of the PIPJ include chronic pain, stiffness, decreased range of motion, joint instability, recurrent dislocations and a fixed flexion deformity.

Adequate rehabilitation following treatment is essential to minimize these complications and optimize functional outcomes. Physical therapy focusing on restoring range of motion, strength, and joint stability is typically recommended post-treatment. Additionally, close monitoring by a healthcare professional is important to detect and address any complications that may arise during the recovery process.

If the injury is severe or associated with instability or joint subluxation, surgical intervention may be necessary. Surgical options include repair or reconstruction of the volar plate using techniques such as direct repair, suture anchor fixation, or tendon graft augmentation. The choice of surgical approach depends on factors such as the extent of the injury, the presence of associated injuries, and the surgeon's preference.

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