Volar plate disruption usually occurs from the distal insertion of the volar base of the middle phalanx. Acute injuries, recognized early, can usually be treated conservatively with protective splinting and supervised range of motion. This article reviews the results of 25 patients over 18 years whom had chronic traumatic volar plate disruptions leading to painful hyperextension deformities treated with volar plate lysis of adhesions and advancement. Mean time from injury to repair was 8.2 years (range 2 months-23 years.)
None of these patients had severe degenerative changes seen on plain radiographs before intervention. Volar plate repair occurred by meticulous scar lysis and advancement to the anatomic site of insertion, avoiding adjacent nutrient vessels. Mean ROM improved from 24°-93° to 6°-92°. Grip strength improved to within 90% of the contralateral side. No patients had recurrence of deformity. No correlation was seen with time between injury and final outcome.