The thumb MCP volar plate is a broad fibrocartilaginous structure containing the radial and ulnar sesamoids in its substance. Hyperextension of the thumb MCP joint avulses the volar plate from the proximal phalanx, producing the gamekeeper's thumb pattern combined with UCL disruption. Skier's thumb injuries frequently involve both the UCL and the volar plate.
| Origin | Palmar base of the thumb proximal phalanx |
|---|---|
| Insertion | Palmar aspect of the first metacarpal neck |
| Actions | Prevents thumb MCP hyperextension; contains the sesamoids in its structure |
|---|
Volar plate avulsion from the thumb proximal phalanx produces a characteristic bony avulsion visible on radiograph at the palmar proximal phalanx base. Extension block splinting for 4-6 weeks manages non-displaced avulsions. Displaced or chronic injuries require surgical repair of the volar plate and UCL complex.
Volar plate detachment from MCP hyperextension managed with extension block splinting or surgical repair for displaced fragments.
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