A volar plate injury refers to damage to the volar plate, a thick ligament located at the base of the finger joints (PIP joints). This structure prevents the joint from bending backward (hyperextension). These injuries commonly occur in sports and are often seen in jammed fingers, dislocations, or forced hyperextension. Prompt treatment is essential to restore normal finger function and prevent long-term deformity (1).
Symptoms
Common symptoms of a volar plate injury include:
- Pain and swelling around the middle joint of the finger
- Bruising and tenderness at the joint’s palm-side
- Difficulty bending or straightening the finger
- A feeling of instability in the joint
- In severe cases, visible deformity or joint dislocation
Symptoms usually develop immediately after the injury and may worsen without proper care (1).
Causes and Risk Factors
Causes:
Volar plate injuries are usually caused by forceful hyperextension of the finger joint. Common scenarios include:
- Sports injuries (e.g., catching a ball wrong in basketball or volleyball)
- Falls on an outstretched hand
- Finger trauma in contact sports or accidents
Risk Factors:
- Participation in ball-handling sports
- Weak finger ligaments or joints
- Previous joint dislocation or sprain
- Poor protective technique during high-impact activities
Complications
If left untreated or mismanaged, volar plate injuries can result in:
- Chronic joint instability
- Flexion contracture or swan-neck deformity
- Decreased grip strength
- Joint stiffness and reduced range of motion
- Arthritis in the long term
Early rehabilitation and correct splinting help prevent these complications (2).
Diagnosis
Doctors typically diagnose volar plate injuries through:
- Physical examination: Checking pain location, joint stability, and movement
- X-rays: To identify joint dislocation or small avulsion fractures (where a bone fragment pulls off with the ligament)
- Ultrasound or MRI (if needed) to assess soft tissue damage
The severity is classified as mild (sprain), moderate (partial tear), or severe (complete tear or with dislocation) (2).
Treatment
Non-Surgical Management:
- RICE protocol: Rest, Ice, Compression, Elevation
- Buddy taping or splinting: To support the injured joint for 2–3 weeks
- Pain relievers like ibuprofen for inflammation
- Gradual motion exercises once pain subsides
- Hand therapy to regain function and avoid stiffness
Surgical Treatment:
- Surgery is rare but may be needed if:
- The joint remains unstable
- There’s a large fracture fragment
- Conservative treatment fails
Surgery typically involves ligament repair and bone fragment fixation (3).
Living With a Volar Plate Injur
Most people recover well from a volar plate injury with early and appropriate care. However, long-term success depends on rehabilitation and joint protection.
Tips for managing daily life after a volar plate injury:
- Adhere to splinting and taping protocols during the healing phase
- Perform stretching and strengthening exercises as advised
- Avoid reinjury by using protective gloves or padding during sports
- Be patient: full recovery may take weeks to months, depending on severity
- Follow up with a hand therapist or orthopedic specialist if stiffness persists
- Maintain joint mobility through regular use and controlled motion
With proper treatment and discipline, most individuals regain full finger function and avoid lasting complications (3).
References
1. Liss, F. E., & Green, S. M. (1992). Capsular injuries of the proximal interphalangeal joint. Hand clinics, 8(4), 755-768.
2. Bowers, W. H. (1981). The proximal interphalangeal joint volar plate. II: a clinical study of hyperextension injury. The Journal of hand surgery, 6(1), 77-81.
3. Durham-Smith, G., & McCarten, G. M. (1992). Volar plate arthroplasty for closed proximal interphalangeal joint injuries. Journal of Hand Surgery, 17(4), 422-428.
