Volar Plate Injury of the Proximal Interphalangeal Joint Clinical Trial
Official title:
A Randomised Controlled Trial Investigating the Effectiveness of Two Splinting Methods in the Non-operative Management of Volar Plate Injuries at the Proximal Interphalangeal Joint
Which splinting method produces the best outcomes (in range of movement, pain and function)
in the non-operative treatment of stable volar plate injuries in adults?
The volar plate is a ligament located at the middle knuckle (proximal interphalangeal joint -
PIPJ) of the finger. It is commonly injured through hyperextension, for example a ball
hitting the fingertip. Current treatment in the Hand Therapy Unit involves splinting the
injured joint dorsally (on the back of the finger) into 20⁰ flexion (bent) using
thermoplastic material. However, there is a potential risk of developing permanent stiffness
of the PIPJ into straightening, once the volar plate ligament heals. To reduce this risk, the
study aims to investigate if using a volar (on the front of the finger) gutter splint in 0⁰
flexion (straight), which still prevents hyperextension, achieves better outcomes. There is
no existing high-quality evidence comparing these two methods.
This is a randomised controlled trial. For the purposes of this study, the current treatment
of a 20° dorsal block splint will act as the control group. The intervention group will be
the volar gutter splint group. A convenience sample will be used and all patients (over 16
years old) presenting to the Mid Yorkshire Hospitals NHS Trust's Hand Therapy Unit will be
invited to participate in the study, with consideration to inclusion/exclusion criteria.
Participants will be randomised into one of two groups through the use of a random number
generator. The outcomes assessed will be range of movement, pain and function. These will be
measured at initial assessment, four and twelve weeks. These are all average normal time
intervals that patients are seen. Each splint is worn for four weeks and participants will
receive standardised advice, exercises and treatment.
n/a