II. Mechanism
- Volar plate injured in forced hyperextension of affected joint
- Usually affects PIP joint
- Partial or complete tear or avulsion Fracture
- Often occurs when the finger is dislocated dorsally
- Associated with PIP Collateral Ligament Injury
- Images
III. Signs
- Tenderness at affected joint at volar aspect
- Evaluate collateral ligaments for stability
- Range of motion remains intact if stable joint
IV. Imaging: XRay
- Avulsion Fracture may be present
V. Management
- Referral indications
- Unstable joint
- Large avulsion Fracture
- Moderate, but stable injury (most cases)
- Progressive extension splint (block splint) of both PIP and DIP joints
- Aluminum splint initially angled 30 degrees flexion
- Progressively decrease flexion weekly by 5-10 degrees
- Week 1-2: 30 degrees
- Week 2-3: 20 degrees
- Week 3-4: 10 degrees
- Week 4: Full extension
- Buddy taping for an additional 2 weeks
- Mild injury
- Buddy taping to adjacent finger for 4 weeks
- Sport participation
- May participate if splinted or buddy taped
VI. Complications
- Hyperextension deformity (Swan-Neck deformity)
VII. References
- Leggit (2006) Am Fam Physician 73(5):810-23 [PubMed]
- Mercier (1995) Practical Orthopedics, p. 314
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Related Studies
Concepts | Acquired Abnormality (T020) |
ICD9 | 736.22 |
ICD10 | M20.03 , M20.039 |
SnomedCT | 23060008 |
English | Finger(s) Swan Neck Deformity, swan neck deformity of finger, acquired swan-neck deformity of finger, acquired swan-neck deformity of finger (diagnosis), swan neck deformity of finger (physical finding), Swan-neck deformity of unspecified finger(s), deformities swan neck, swan-neck deformity, Swan-neck deformity, Swan-neck deformity of finger, Swan-neck deformity (disorder) |
Dutch | zwanehalsmisvorming van vingers |
French | Déformation en col de cygne |
German | Schwanenhalsdeformitaet |
Italian | Deformazioni a collo di cigno |
Portuguese | Deformação em colo de cisne |
Spanish | Deformidad en cuello de cisne, deformidad en cuello de cisne (trastorno), deformidad en cuello de cisne |
Japanese | スワンネック変形, スワンネックヘンケイ |
Czech | Deformita tvaru labutí šíje |
Hungarian | Hattyúnyak deformitás |
Ontology: Volar plate injury, finger, proximal interphalangeal joint (C0434451)
Concepts | Injury or Poisoning (T037) |
SnomedCT | 209489004 |
English | Volar plate injury finger PIPJ, Volar plate injury, finger, proximal interphalangeal joint, Volar plate injury, finger, proximal interphalangeal joint (disorder) |
Spanish | lesión de placa palmar, dedo de la mano, articulación interfalángica proximal (trastorno), lesión de placa palmar, dedo de la mano, articulación interfalángica proximal |
Ontology: Volar plate injury of finger joint (C0435000)
Concepts | Injury or Poisoning (T037) |
SnomedCT | 263125003 |
English | Volar plate injury finger jt, Volar plate injury of finger joint, Volar plate injury of finger joint (disorder) |
Spanish | lesión de la placa palmar de articulación de dedo (trastorno), lesión de la placa palmar de articulación de dedo |