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Understanding Anthony Davis’ Volar Plate Injury

New Orleans Pelicans big man Anthony Davis was expected to miss one-to-two weeks with a sprained left index finger. However, the Athletics’ Shams Charnia revealed that Davis is slated to visit with a hand specialist to rule out a very specific injury known as a volar plate avulsion fracture.

The volar plate, or plantar plate, is a fibrocartilage structure that increases the articulating surface of the finger joints while providing protection and additional stability. It sits on the palm side of the hand between the proximal and middle bones of each finger at a joint known as the proximal interphalangeal (PIP) joint. Designed to limit excessive extension of the PIP, the volar plate can be injured if the joint is bent backward in hyperextension. When this occurs, the volar plate often remains intact but pulls away a small piece of bone. This type of injury is known as an avulsion fracture.

Conservative treatment utilizing a specifically designed brace is the preferred route of care. Nonoperative treatment has a high success rate and good prolonged outcomes though complete healing often take a considerable amount of time. However, surgery may be necessary if a significant portion of the bone has been damaged. Recovery is often measured in weeks, not days.

Finding a good NBA comparison is difficult. The InStreetClothes.com/SMART database has just one confirmed volar plate injury. During the 2007-08 season, Los Angeles Laker guard and former MVP Kobe Bryant suffered a volar plate tear of his right pinkie. Surgery was recommended but Kobe initially delayed going under the knife to avoid missing playing time. The 2008 Beijing Olympics forced Kobe to once again push back the procedure. However, he opted to forgo the operation completely prior to the 2008-09 season when doctors suggested the recovery could take up to 12 weeks. As a result, Bryant did not miss any time.

However, Bryant’s injury was to his pinkie, not his index finger. Davis would have a much more difficult time playing through this type of injury. Charnia reported that confirmation of the volar plate injury would keep Davis out for at least two-to-four weeks. Unfortunately, surgery would potentially extend that window, leaving the Pelicans without the face of their franchise for a significant stretch of the season.

UPDATE: On Wednesday, ESPN’s Adrian Wojnarowski reported that the volar plate avulsion fracture has been confirmed but that Davis could be back as early as next week. These findings appear to rule out surgery and suggest Davis will be able to play as long as he can manage the associated symptoms like pain and swelling.