Treatment of Sagittal Plane Instability of the Proximal Interphalangeal Joint through Volar Plate Repair

Abstract

Incompetence of the volar plate of the proximal interphalangeal (PIP) joint can cause instability in the sagittal plane, repetitive dorsal dislocations, pain, and functional disability. The authors herein present five cases of repeated dorsal dislocations of the PIP joint secondary to rupture and incompetence of the volar plate. The patients were aged between 17 and 45 years, and the time elapsed from injury to intervention ranged from 16 weeks to 14 years. Volar plate repair was possible in all cases, resulting in joint stabilization. The mean postoperative follow-up period was of 18 months. Of the five cases, the outcomes were excellent in three, good in one, and fair in one, according to the Catalano et al.2 criteria. Direct volar plate repair is a reliable technique to treat volar plate incompetence resulting in repeated dorsal dislocation of the PIP joint, regardless of the time from injury to intervention.

Keywords

• proximal interphalangeal joint
• volar plate
• hyperextension deformity
• swan neck deformity
• late volar plate repair