The DIP joint volar plate is a thick fibrocartilaginous structure on the palmar aspect of the distal interphalangeal joint, connecting the distal portion of the middle phalanx to the base of the distal phalanx. It prevents DIP hyperextension and provides a smooth articular surface for the flexor digitorum profundus tendon. It is thinner and less robust than the PIP volar plate.
Prevents DIP joint hyperextension, provides articular surface coverage for the FDP tendon as it passes to the distal phalanx, and reinforces the palmar capsule of the DIP joint.
The DIP volar plate is disrupted in hyperextension injuries of the DIP joint and can avulse with a bony fragment from the base of the distal phalanx. More commonly, mallet injuries involve the dorsal extensor tendon or extensor-base avulsion rather than the volar plate. However, complex DIP dislocations can injure both the volar plate and the collateral ligaments, producing instability. In Kirner deformity, the volar plate and digital fascia contribute to progressive DIP volar flexion deformity of the little finger.
Forced DIP hyperextension avulses the volar plate from its distal phalanx attachment with or without a bony fragment, producing painful DIP instability in the palmar direction, managed by buddy-taping or splinting in slight flexion for volar plate-only injuries.
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