Volar plate avulsion fracture

This is a patient who presented with pain and swelling of the index finger following a hyperextension injury. Frontal and lateral radiographs were obtained. The frontal radiograph demonstrates circumferential soft tissue swelling of the finger, which is most prominent at the proximal interphalangeal joint. The lateral radiograph demonstrates a minimally displaced fracture from the volar base of the middle phalanx as indicated by the red arrow. This fracture represents an avulsion fracture where the volar plate pulls off a small piece of bone at its attachment site. The volar plate attaches the volar aspect of the proximal phalanx to the middle phalanx. With forceful hyperextension, the volar plate may either tear or my avulse a small piece of bone, as in this case.