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My experience with a volar plate avulsion fracture (finger)
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Aug 5, 2012, 4:15 AM
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Registered: Nov 21, 2007
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My experience with a volar plate avulsion fracture (finger)
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This is mostly for the benefit of anyone who might experience the same injury.

October 2011: While climbing on the same night as doing heavy deadlifts, I feel pain in my middle finger after a sequence of small open-hand holds. I try climb easy for the rest of the night but only make it worse. Over the next few days I can tell I've injured my finger and stop climbing.

late-November 2011: In preparation for a Thanksgiving trip I've had planned for months, I go back to the climbing gym twice. My finger still hurts. I climb long easy routes on my trip and my finger actually feels okay, surprisingly. I climb four or five days on and experience little pain.

early-December 2011: Thinking my finger is mostly healed, I go back to the gym. I immediately re-injure my finger, this time feeling a pop. I cannot extend and contract my finger smoothly; instead, it clicks and catches as I try to extend it. It also hurts a lot to move it from side to side. I know I've likely ruptured one or more ligaments, including the collateral ligament. More time off.

late-December 2011: Another planned trip. Long easy routes. Finger still hurts.

mid-January 2012: X-rays show that I have pulled off a tiny plate of bone from my middle phalanx where the ligament connecting the proximal and middle phalanxes inserts (basically, a small plate of bone below the middle pad of my finger).

The orthopedic surgeon tells me surgery is not an option and tells me to simply not do anything that hurts the finger including climbing for the indefinite future. He is quite dismissive. At this point it hurts to carry a light grocery bag and I am depressed because I might never climb like I used to.

I schedule appointments with several other orthopedic surgeons. The first one I meet with tells me it is too late for surgery, but that I can expect 90% of my finger strength by splinting my finger at an angle for 6-8 weeks (to aid the scar tissue in forming). I do the splint.

early-March 2012: At the 6 week point, I take the splint off and my finger feels the same as it did in January. I see two more orthopedic surgeons. X-rays show the plate is still avulsed. One of the doctors recommends taking the splint off (now at 8 weeks) and doing physical therapy.

late-April 2012: Another climbing trip. I have barely climbed for 6 months. I'm surprised to find my finger is feeling quite a bit better, although it still hurts a little bit.

May-July 2012: I recover to 95-99%+ and start going back to the gym 1-3 times a week. I only feel pain on hard dynamic moves and back off when anything doesn't feel right.


This and other injuries in the past year have made me much more cautious with my body. 7 years ago when I started climbing, I had finger tendon/ligament injuries that felt similar to the volar plate avulsion. They healed with little or no time off. However, the volar plate fracture did not.

If I had gotten an X-ray right after the injury, the doctor would have splinted it immediately and it probably would have healed in 4 weeks (the splint is most effective right after this type of fracture). Every doctor I saw asked me why I didn't get medical attention when I injured my finger initially.

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