[Surgical indication for injuries to the palmar plate of the PIP joint]

Injuries to the proximal interphalangeal (PIP) joint are often discounted as trivial although they can lead to instability and even more frequently to contracture of the PIP joint. Distortion and hyperextension traumata are the most common causes of PIP joint injuries of the hand and frequently occur in conjunction with sports-related injuries. Treatment concepts demonstrate considerable agreement. There is consensus of opinion that the predominant proportion of injuries can be assigned to conservative therapy.The basic diagnostic evaluation of the injured finger consists in X-rays taken in two planes. The examiner must always compare the stability of the PIP joint with the uninjured side. During functional assessment of the joint's stability a distinction can be made between active and passive stability.Injuries of the palmar plate with and without small bone fragments that do not exhibit subluxation after repositioning and X-ray control are immobilized during the phase of acute pain in a palmar splint in the intrinsic plus position for a maximum of 5 days. Thereafter the patient independently performs movement exercises.