Reconstruction of the metacarpophalangeal volar plate with the A1 pulley and 11 cases of proximal interphalangeal/metacarpophalangeal volar plate injuries in adolescent age.

Finger injuries involving the proximal interphalangeal joint (PIPJ) plate are common, but injuries involving the metacarpophalangeal joint (MCPJ) plate are rare. Injury severity is often underappreciated as a "jammed finger". Delayed diagnosis and treatment can have an essential impact on regaining full function. From 2010 to 2021, we dealt with a total of twelve cases of volar plate lesions, eight boys and four girls, from 13 to 16 years of age, eight of them were treated surgically, two with dorsal pinning and two with dorsal block splinting. No significant differences between the patients treated conservatively and operatively were found concerning treatment duration, required physiotherapy and total active motion. No patient developed palmar joint instability, and a painless, stable joint and full grip function was achieved. Surgical treatment of the volar plate injuries is indicated in the case of joint instability, subluxation, persistent swelling, limited range of motion or the presence of dislocation of a bone fragment grade 3-4. Conservative treatment for cases with small or no fragment dislocation is recommended. Untreated volar plate injuries can lead to permanent loss of function, inadequate treatment leads to persistent swelling, instability, and limited range of motion, which are difficult to treat.