Conservative treatment of stable volar plate injuries of the proximal interphalangeal joint in children and adolescents: a prospective study.

Abstract

OBJECTIVES:

The purpose of this study was to assess a standard conservative management for stable volar plate injuries of the proximal interphalangeal joint in children and adolescents. No study is available regarding this subject for this age group.

METHODS:

A prospective study was performed on 37 consecutive patients (aged between 9 and 15 years; mean, 13 years) with stable acute volar plate injuries of the proximal interphalangeal joints, including 22 avulsion fractures without dislocation. All patients had a standardized conservative treatment consisting of a dorsal aluminum extension block splinting at a 15-degree flexion for 10 days, followed by a spontaneous mobilization and taping to adjacent fingers for sports only. At follow-up visits, active and passive ranges of motion, swelling of the affected joints, analgesic intake, and pain perception by the patient were recorded. Regular follow-up consisted of standardized assessments at 2, 6, and 12 weeks, with additional consultations if symptoms persisted.

RESULTS:

Healing was uneventful, and hand therapy was not necessary to regain full range of motion in 32 of 33 children with a regular follow-up. The only flexion contracture observed responded well to splinting. Of the 33 patients, 31 had an excellent outcome and 2 had a good outcome.

CONCLUSIONS:

Dorsal extension block splinting was an efficient, simple, well-tolerated treatment for stable volar plate injuries of the proximal interphalangeal joint in a preliminary series of patients younger 16 years. Flexion contractures were rare and responded well to dynamic splinting.

• Authors: Daniel M Weber, Christian J Kellenberger, Martin Meuli
• Journal: Pediatric emergency care (Pediatr Emerg Care) Vol. 25 Issue 9 Pg. 547-9 (Sep 2009) ISSN: 1535-1815 [Electronic] United States
• PMID: 19755884 (Publication Type: Comparative Study, Journal Article)

Topics

• Adolescent
• Child
• Finger Injuries (physiopathology, therapy)
• Finger Joint (physiopathology)
• Follow-Up Studies
• Humans
• Immobilization (instrumentation)
• Palmar Plate (injuries)
• Prospective Studies
• Range of Motion, Articular (physiology)
• Retrospective Studies
• Splints
• Treatment Outcome