Pediatric Volar Plate Management: A Pilot Study

Area of Science:

• Pediatric Orthopedics
• Hand Surgery
• Sports Medicine

Background:

• Proximal interphalangeal (PIP) joint volar plate injuries are frequent in pediatric hand cases.
• Current treatment options like splinting or buddy taping lack a definitive best practice consensus.
• This study addresses the need for evidence-based treatment guidelines in pediatric hand injuries.

Purpose of the Study:

• To compare treatment outcomes for pediatric proximal interphalangeal (PIP) joint volar plate injuries.
• To evaluate the efficacy of splinting followed by buddy taping versus direct buddy taping.
• To inform the sample size calculation for a future larger equivalency study.

Main Methods:

• A prospective observational pilot study was conducted on children with stable PIP joint volar plate injuries.
• Patients were treated with either 1-2 weeks of splinting then buddy taping, or direct buddy taping.
• Outcomes measured included patient-reported pain, range of motion (ROM), and time to return to activity.

Main Results:

• The direct-to-buddy taping group exhibited significantly better active ROM and less pain at 1-2 weeks post-injury compared to the 1-week splinting group.
• No significant differences in ROM or pain were observed between the groups at the 4-week follow-up.
• One patient in the direct-to-buddy taping group experienced a delayed return to activity due to pain.

Conclusions:

• Both treatment protocols (splinting followed by buddy taping or direct buddy taping) yield similar outcomes at 4 weeks for pediatric PIP joint volar plate injuries.
• The findings support the initiation of a larger, powered equivalency trial to confirm these results.
• This research contributes to optimizing treatment strategies for common pediatric hand injuries.