Management of Volar Plate Avulsion Fractures

Initial Management and Immobilization Period

• Active finger motion exercises should be initiated immediately following diagnosis to prevent stiffness, which is one of the most functionally disabling adverse effects of hand fractures 2

Progression to Protected Weight Bearing

• This approach is supported by evidence from studies of other fractures where early protected weight bearing (≤2 weeks) with devices limiting dorsiflexion showed improved outcomes 3

Monitoring and Follow-Up

• Radiographic follow-up after the initial 2 weeks should be considered only if clinically indicated (e.g., new trauma, significant pain, loss of range of motion, or neurovascular symptoms) 1

Introduction to Weight Bearing

• For volar plate avulsion fractures, weight bearing should be avoided for approximately 2 weeks, after which protected weight bearing with a splint that limits dorsiflexion can be initiated 1