Ghidella Sean D, Segalman Keith A, Murphey Mary Schuler
Curtis National Hand Center, Baltimore, MD, USA.
J Hand Surg Am. 2002 Sep;27(5):799-805. doi: 10.1053/jhsu.2002.35303.
To evaluate the long-term results of surgical treatment of proximal interphalangeal (PIP) joint contractures, 68 PIP joints were retrospectively reviewed with a minimum follow-up period of 24 months. Preoperative and intraoperative factors were studied for outcomes and subjected to statistical analysis. Among the total group the average improvement was 7.5 degrees. When grouped by diagnosis into simple (less severe diagnoses) and complex (more severe diagnoses) the average degrees gained were 17.2 degrees and 0.5 degrees, respectively. The statistically significant factors that were identified that affected results were age, number of prior procedures, preoperative flexion, removal of an exostosis, number of structures addressed, and preoperative arc of motion. The second surgery (joints requiring repeat release or salvage procedure) rates were 35% overall, 29% simple, and 39% complex; the difference was not significant. The best surgical candidate is a patient younger than 28 years with a less severe diagnosis and who has preoperative maximum flexion measurement < 43 degrees.
为评估近端指间（PIP）关节挛缩手术治疗的长期效果，对68个PIP关节进行了回顾性研究，最短随访期为24个月。研究术前和术中因素对结果的影响并进行统计分析。在整个研究组中，平均改善角度为7.5度。按诊断分为单纯性（病情较轻）和复杂性（病情较重）两组时，平均改善角度分别为17.2度和0.5度。确定的影响结果的具有统计学意义的因素包括年龄、既往手术次数、术前屈曲度、骨赘切除情况、处理的结构数量以及术前活动弧度。二次手术（需要重复松解或挽救手术的关节）率总体为35%，单纯性为29%，复杂性为39%；差异无统计学意义。最佳手术候选者是年龄小于28岁、诊断较轻且术前最大屈曲度测量值<43度的患者。
