A small bursa at the palmar aspect of the proximal interphalangeal joint, between the volar plate and the flexor tendon sheath, reducing friction as the flexor tendons slide across the volar plate during finger flexion.
PIP joint palmar bursitis occurs in volar plate injuries from hyperextension sprains and in PIP joint synovitis from inflammatory arthropathy. It is distinct from the already documented PIP joint dorsal bursa. Ultrasound demonstrates palmar PIP joint fluid collection. Volar plate injuries require splinting in slight flexion to prevent contracture.
Hyperextension injury avulsing the volar plate from the middle phalanx base with palmar PIP joint bursitis, producing palmar PIP tenderness and instability managed by buddy strapping and extension block splinting.
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