The finger is made up of several small bones with the joints being supported by strong ligaments; one of these ligaments is called the volar plate. It helps to support the joint and prevents it from being over stretched or dislocated.
A volar plate injury occurs when the middle joint of the finger (PIP joint) is forced backwards and overstretched. It is a common injury and usually occurs with falls, ball sports and activities of daily living. It can be either partially torn, fully torn and in some instances the injury can cause a small fracture of the bone at the base of the joint. The volar plate can also be injured if the joint is dislocated.
Area of injury
What are the signs and symptoms of a volar plate injury?
- Pain straight after an injury
- Noticeable swelling or deformity around the joint
- Pain when moving the finger or if it is resting
- Unable to fully move the finger/joint and pain with gripping
Healing
Most volar plate injuries will heal in about 6-12 weeks. You should regain your movement quickly within this time with regular exercise, although symptoms of pain, stiffness, swelling and reduced strength may persist for several months.
What is the treatment?
Treatment usually involves ‘buddy strapping’ the injured finger to another finger to give it support as it heals and at the same time will allow you to move your fingers more comfortably. The strapping should not be too tight.
We encourage early movement of the finger(s) with this type of injury to prevent stiffness at the middle finger (PIP) joint. You must try to regain the normal movement in your hand as soon as possible with the exercises below.
You normally do not need any follow up after this type of injury, although if you are struggling with the movement of your finger 6 weeks after the injury then please get in contact on the telephone number below.
What can I do to help?
- You can take regular over the counter painkillers to help with pain relief
- Use your hand normally, as comfort allows, for daily tasks ie; washing, dressing
- You can return to work or school as soon as pain allows
- Avoid bending the finger fully backwards (hyperextension) at the injured (PIP) joint
Complications
These injuries usually heal by themselves without any complications. An associated fracture with the joint may have an increased tendency to become stiff. In some instances, a fixed flexion contracture can occur and chronic swelling can be common of the finger joint. The joint can be achy for a few months after your injury.
Exercises
| Weeks since injury | Plan |
| 0 – 3 | Keep the strapping on for the first 2-3 weeks (including when doing the exercises below)Keep your fingers moving to prevent stiffness, exercises as below |
| 3 – 6 | Aim to get full movement in the fingerGradually increase strenuous activities as pain allows |
| 6 – 12 | The injury should have healed around 12 weeksReturn to all activities as pain allowsFull contact sport and heavy lifting should be avoided for at least 6 weeks until symptoms have settled |
| 12+ | If you are still experiencing significant pain and swelling, please contact the number below |
Stage 1 exercises
The aim is to make a fist but do not force the movement and work within your limits as pain and swelling allows. Perform the exercises slowly and regularly every day to help you regain full movement. Initially pain and swelling will restrict the movement, this is normal at this stage. Work through the following sequence. You can do these exercises with the strapping on.
Repeat each x 5-10, several times per day
Touch each finger to your thumb, repeat x 5, several times per day
Stage 2 exercises
At 2 weeks, the aim is to fully straighten your finger as pain allows and continue to fully bend it. Use your other hand to keep your finger steady, support underneath the joint to be moved, then bend and straighten the joints in all your fingers. If finger joints become stiff in a bent position, hold them in a straighter position with the help of the other hand. Hold the position for 10 seconds. Repeat x 5
From 4-6 weeks
You can exercise the fingers with very mild resistance and increase it gradually as pain allows (for example squeezing a light sponge, pair of socks, soft putty or playdoh). You should avoid heavy lifting, gripping or contact sports until at least 6 weeks when the finger is feeling better.
Return to Work or Driving
You can return to work when you feel able to manage physical tasks required in your Job. You can return to driving when you feel confident in operating the car safely and you can safely perform an emergency stop, have good grip strength and are not in significant hand pain. It is not advised to drive if you have a splint, tape or straps on your hand. Please refer to the DVLA website regarding fitness to drive or your insurance company if you are unsure.
Concerns
If you have pain which is continuous and not improving, you are unable to use your hand or you have any concerns about your injury, please get in touch with the Urgent Care Centre at the Queen Elizabeth hospital on 0191 445 6756.
How do I make a comment about my visit?
We aim to provide the best possible service and staff will be happy to answer any of the questions you may have.
If you have any suggestions or comments about your visit, please either speak to a member of staff or contact the patient advice and liaison service (PALS) on 0191 445 6129 (09.00 – 17.00, Monday to Friday).
You can also email PALS at [email protected]
Alternatively, you may wish to complain by contacting our complaints department:
Chief Executive,
Gateshead Health NHS Foundation Trust,
Trust Headquarters,
Queen Elizabeth Hospital,
Sheriff Hill,
Gateshead,
NE9 6SX
The PALS team will listen to your concerns, suggestions or queries and is often able to help solve problems on your behalf.
Data Protection
Any personal information is kept confidential. There may be occasions where your information needs to be shared with other care professionals to ensure you receive the best care possible.
In order to assist us to improve the services available, your information may be used for clinical audit, research, teaching and anonymised for National NHS Reviews and Statistics.
Further information is available via Gateshead Health NHS Foundation Trust website (Privacy – QE Gateshead) or by contacting the Data Protection Officer by telephone on 0191 445 8418 or by email [email protected].
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