Condition Spotlight: Volar Plate Injury by Amy Eckert, Occupational Therapist Doctoral Candidate, OTS

What is a Volar Plate Injury?

The volar plate is a strong ligament that connects bone to bone at the bottom of the middle joint of the fingers which prevents hyperextension, however, if this ligament is forcefully extended it can partially or completely tear. This injury can cause pain, swelling, stiffness, and general issues using the finger into functional tasks. 

Volar Plate Injury Symptoms

Symptoms may include:

  • Pain and tenderness at the injury site 
  • Swelling and discoloration
  • Lack of joint motion 
  • Joint instability
  • Joint misalignment if dislocated 

 

Cause of a Volar Plate Injury

The cause of a volar plate injury can be related to trauma to the finger like when catching a ball, falling on an out stretched hand, or from a motor vehicle accident. When the middle joint of the finger is hyperextended, then it can cause that partial or complete tear of the volar ligament. Diseases such as Rheumatoid Arthritis can increase chances for injury to the volar plate due to weakening the strength of the ligament, as well. 

 

Conservative treatment for Volar Plate Injuries

First line of treatment would include RICE protocol to include rest, ice, compression, and elevation of the affected finger. Your OT will suggest exercises based on your injury severity and can provide splinting for the finger. The splint itself will go over the top of the affected finger to maintain a mild bent position to facilitate proper healing of the ligament. A technique called buddy taping may also be useful to try.

 

Volar Plate Injury Surgery

If the ligament is completely torn or instable, then surgery may be warranted to improve functional outcomes. Surgery may include but is not limited to volar plate repair or volar plate arthroplasty. 

 

Precautions/Contraindications?

It is important to rest the affected finger in the splint to prevent further damage to the ligament while it heals. Be sure to complete the exercises given to you by your OT to address areas of concern so that the finger can return to its prior level of function. Do not over-use the affected finger into tasks especially at the initial stages of the injury. 

 

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4894366/

https://centralcoastortho.com/patient-education/volar-plate-injuries/

 

A little bit about Amy Eckert, our visiting OT student…

Hi! My name is Amy and I am Creighton University Occupational Therapy Student completing my Doctoral Capstone Experience at Colorado Springs Therapy Center for the past 14 weeks. I plan to graduate with my Doctorate in Occupational Therapy in May 2022 and have hopes to specialize in hand therapy with an ultimate goal of becoming a Certified Hand Therapist. I have completed other fieldwork experiences where I provided direct care to clients in a hand therapy setting which further sparked my interest in specializing. I have always been interested in anatomy and passionate about serving others in a healthcare profession so occupational therapy has allowed me to combine both interests! One of my favorite quotes which I feel embodies occupational therapy and hand therapy is, “Man, through the use of his hands as they are energized by mind and will, can influence the state of his own health” -Mary Reilly, OT

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