Volar Plate Injury
The Volar Plate is basically a very thick ligament which separates the joint space of the proximal interphalangeal (PIP) joint - the first knuckle on the finger, and the flexor tendons. The volar plate goes from the proximal phalange (finger bone nearest the hand) to the middle phalange.
Symptoms of a Volar Plate Injury
- Immediate pain in the finger.
- Pain is located over the middle finger joint.
- Swelling usually develops quite quickly.
- The finger may appear deformed.
- It will be painful to try to move that joint.
- Bruising may appear, especially on the palm side of the middle finger joint.
This injury most frequently occurs due to a hyperextension force - where the finger is overstraightened and pushed backwards. It is sometimes known as a 'jammed finger'. The injury can just be to the ligament, or can be an avulsion fracture where the ligament pulls off a small peice of bone at its attachment. This may also involve damage to the collateral ligament - known as a finger sprain.
The most common cause of this injury in sports is ball sports where the ball forces the fingers backwards.
Treatment
An X-ray should be sought to determine if there has been an avulsion fracture, or whether the damage is purely soft tissue related.
If the injury is just to the ligament then it should be immobilised in a splint for a few days, up to a week to allow healing to occur. Then gentle range of motion exercises can begin to prevent stiffening. Buddy strapping should still be used inbetween exercises until pain free to aid healing.
If a fracture is present, it may require surgical fixation with wires or pins before immobilisation.
