A scoping review of conservative treatment approaches for volar plate injuries of the proximal interphalangeal joints in an acute health care setting

Background: A volar plate injury (VPI) of the proximal interphalangeal joints (PIP) is a common injury that occurs when a finger is hyperextended, rupturing or separating the thick ligament from the bone on the finger's palm side. The degree of damage determines the course of treatment. For stable injuries without dislocation, conservative treatment such as hand rehabilitation, splinting, and rest is typically recommended. It is crucial to explore the effectiveness of conservative treatment of VPIs, as evidence suggests that surgical treatment is often over-utilised in these cases. Methods: A scoping review was conducted using the framework by Arksey and O'Malley (2005). Studies of all research designs published between January 2014, and January 2024 were included to ensure that the review reflects the latest practices in the conservative treatment of VPIs in individuals. A search of six electronic databases: CINAHL, MEDLINE, Science Direct, Scopus, Web of Science, Cochrane Library, along with grey literature, was conducted. Inductive content analysis was used to examine the data. The review is reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-analysis for Scoping Reviews (PRISMA-ScR). Findings: Fourteen papers met the inclusion criteria. Two themes emerged addressing the importance of early diagnosis and intervention and comparing different conservative treatments. The findings also emphasise variability in management strategies and highlight the necessity for further research to enhance the evidence base for clinical practice. Conclusion: Current evidence suggests that conservative treatment of VPIs of the PIP joints in an acute health care setting is an effective treatment approach. Early identification and intervention are important in reducing functional loss and deformities associated with VPIs. Dynamic ultrasound, orthotic devices, and mobilisation approaches are seen to be effective therapeutic techniques that enhance the range of movement and functional outcomes.