[Rupture of the palmar plate--conservative or surgical therapy]

Disruptions of the palmar plate are frequently overlooked injuries. As the palmar plate stabilises the PIP joint in combination with the collateral ligaments untreated injuries may result in severe complaints. Detailed anatomical and functional knowledge is therefore necessary to diagnose the degree of injury. In addition to ligamentous disruption osseous chips may occur and can be divided into four degrees (Hintringer 1987). By the study of results of 178 cases specific treatment has been established. Surgical intervention is indicated in the presence of an unstable PIP joint, subluxation or osseous chips grade 3 and 4 (Hintringer). The aim should be a painfree and stable joint. Small limitations in movement can be tolerated.