Managing volar plate finger injuries with two different splints

This randomised controlled trial will compare two treatment methods for management of stable volar plate injuries to the proximal interphalangeal joint of the finger. The aim is to determine if management with figure 8 splinting with an exercise plan provides similar or improved results to the current treatment used in the hand clinic of dorsal block splinting with an exercise plan. The only variation in treatment between the two groups will be the splint participants are provided. The figure 8 splint is less restrictive and allows more functional use of the hand with the splint on. Each splint is made out of thermoplastic (orfit, 1.6mm thickness) and is fabricated specifically for each patient. Participants will be randomly assigned to one of the two treatment groups and will follow the designated treatment protocol for those groups. Each participant will be assessed by either an occupational therapist or physiotherapist experienced in the management of volar plate injuries. Each treating clinician will assess, fabricate splints, complete measurement and provide the exercise plans. All of these procedures will be completed during a face to face treatment session. Measurement will be quantitative, using goniometry (measuring finger range of movement), visual analogue scale (VAS) to measure pain severity, circumferential oedema measurement, and the Disabilities of the Arm, Shoulder and Hand scale. Measurement will occur at the time of initial assessment, and at approximately 4 and 12 weeks after commencement of treatment. The home exercise plan consists of active and passive movements of the metacarpal phalangeal, proximal interphalangeal and distal interphalangeal joints which are completed 5 times a day (10 repititions of active hooks and fists, 5 repititions of 20 second stretches into flexion).