Volar Plate

Middle and Proximal Phalanges 285 Condyle Fractures (Intra-articular) 285 Phalangeal Neck Fractures 286 Phalangeal Shaft 286 Proximal Phalanx 286 Volar Plate and... 

Volar Plate and Central Slip Avulsion Fractures... 

Volar plate injuries occur due to forced hyperextension of the proximal interphalangeal joint (PIPJ). There is avulsion of the insertion of the volar plate from the epiphysis at the base of the middle phalanx volarly, often only seen on the lateral or oblique radiographs (Fig. 19.17). Large fragments may require internal fixation. If they are unrecognised or progress to malunion, a swan neck deformity will... 

The MCP joint is the most frequently dislocated joint in the child s hand, usually a dorsal dislocation of the index finger. This digit also has the highest proportion of complex or irreducible dislocations. The volar plate ruptures from its insertion on the metacarpal as the proximal phalanx moves dorsally, and may become interposed between the articular surfaces, blocking reduction. The metacarpal head may also become fixed by the surrounding soft tissues (Kaplan 1957). Open reduction of these complex dislocations is usually required. 

From Tarallo L, Mugnai R, Adani R, Zambianchi F, Catani F. A new volar plate made of carbon-fiber-reinforced polyetheretherketon for distal radius fracture analysis of 40 cases. J Orthopaed Traumatol 2014 15 277-83. 

So-called turf toe describes a sprain of the first metatarsophalangeal joint in which there is partial or complete disruption of the plantar plate, presenting with persistent hyperextension of the proximal phalanx. Similar to the volar plate in the hand, the... 

Fig. 11.53a,b. Interphalangeal joint synovitis, a Longitudinal 15-7 MHz US image over the palmar aspect of the proximal interphalangeal joint with b diagram correlation demonstrates mild effusion inside the volar synovial recess (arrowheads) of the joint. Note the relationship of this recess with the palmar plate (asterisk), the flexor tendons (ft) and the edge of the head of the proximal phalanx (star). In b, the dorsal recess (arrow) of the joint is also depicted. PP, proximal phalanx MP, middle phalanx... 

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