Mechanism
1. Volar plate injured in hyperextension of affected joint
  1. Usually affects PIP joint
  2. Partial or complete tear or avulsion Fracture
  3. Often occurs when the finger is dislocated dorsally
2. Associated with PIP Collateral Ligament Injury
Signs
1. Tenderness at affected joint at volar aspect
2. Evaluate collateral ligaments for stability
3. Range of motion remains intact if stable joint
Imaging: XRay
1. Avulsion Fracture may be present
Management
1. Referral indications
  1. Unstable joint
  2. Large avulsion Fracture
2. Moderate, but stable injury (most cases)
  1. Progressive extension splint (block splint)
  2. Aluminum splint initially angled 30 degrees flexion
  3. Progressively decrease flexion weekly by 5-10 degrees
    1. Week 1-2: 30 degrees
    2. Week 2-3: 20 degrees
    3. Week 3-4: 10 degrees
    4. Week 4: Full extension
  4. Buddy taping for an additional 2 weeks
3. Mild injury
  1. Buddy taping to adjacent finger for 4 weeks
4. Sport participation
  1. May participate if splinted or buddy taped
Complications
1. Hyperextension deformity
References
1. Leggit (2006) Am Fam Physician 73(5):810

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 6/1/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.