Comparing two different interventions for treatment of volar plate injuries.

Group 1 will receive their initial treatment within in 14 days of sustaining their injury and will be treated in a dorsal blocking orthosis in a neutral position, full-time and commence Active Range of Motion (AROM) within the orthosis. This will involve isolated distal interphalangeal joint flexion/extension exercises, proximal interphalangeal joint flexion/extension exercises and composite flexion/extension exercises and will be asked to be completed 10 repetitions, 6 times per day. Patients will be shown how to complete these exercises at their initial treatment session and will be asked to complete them at home and will be reviewed and assessed at the treatment sessions by the treating hand therapist. The initial treatment session is anticipated to take approximately 45 minutes for treatment and 30 mins for assessment. The orthosis will be weaned if clinically appropriate at week 3 (post intervention), where by the patient will need to continue to wear it for sleeping and 'at risk' situations/activities. If clinically appropriate the orthosis will be discharged at week 5 (post intervention). Patient will be asked how often they are completing their exercises at each assessment point and a questionnaire will be completed at the 3 week assessment (3 post intervention) to assess adherence to treatment, including splinting. Subsequent treatment sessions are anticipated to take approximately 30 minutes for treatment and 30 minutes for assessment.