Lin Sung-Yen, Chuo Chin-Yi, Lin Gou-Tyan, Ho Mei-Ling, Tien Yin-Chun, Fu Yin-Chih
Department of Orthopaedics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
J Hand Surg Am. 2008 Jan;33(1):35-9. doi: 10.1016/j.jhsa.2007.10.020.
To evaluate the results of volar plate interposition arthroplasty for posttraumatic arthritis in proximal interphalangeal (PIP) joints and metacarpophalangeal (MCP) joints.
Seven patients who had volar plate interposition arthroplasty performed by a single surgeon for posttraumatic arthritis in PIP joints or MCP joints were retrospectively reviewed after a minimum follow-up period of 2 years (average, 30 mo). Clinical assessments included the range of joint motion, joint alignment according to radiographs, stability under manual stress, and a visual analog pain scale. The results of clinical assessments at the final follow-up evaluation were compared with the preoperative values.
The average arc of motion increased greatly from 11 degrees preoperatively to 75 degrees at the follow-up evaluation. The instability and pain of the preoperative joints were also well corrected after surgery. The final follow-up radiography showed the reduction of the operated joint. The visual analog pain scale improved from an average of 9 before surgery to 1 at the final evaluation, indicating positive subjective evaluation.
At the minimum 2-year follow-up, volar plate interposition arthroplasty provided satisfactory results in terms of pain relief and functional preservation for finger joints with posttraumatic arthritis. We suggest that volar plate interposition arthroplasty may be a good therapeutic option for posttraumatic arthritis in PIP joints or MCP joints.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
评估掌板置入关节成形术治疗近端指间关节（PIP）和掌指关节（MCP）创伤后关节炎的效果。
回顾性分析由同一位外科医生对7例PIP关节或MCP关节创伤后关节炎患者进行掌板置入关节成形术的病例，随访期至少2年（平均30个月）。临床评估包括关节活动范围、X线片所示关节对线情况、手法应力下的稳定性以及视觉模拟疼痛评分。将最终随访评估时的临床评估结果与术前值进行比较。
平均活动弧度从术前的11度大幅增加到随访评估时的75度。术前关节的不稳定和疼痛在术后也得到了很好的纠正。最终随访X线片显示手术关节复位。视觉模拟疼痛评分从术前平均9分改善到最终评估时的1分，表明主观评价良好。
在至少2年的随访中，掌板置入关节成形术在缓解疼痛和保留创伤后关节炎手指关节功能方面取得了满意的效果。我们认为掌板置入关节成形术可能是治疗PIP关节或MCP关节创伤后关节炎的一个良好治疗选择。
研究类型/证据水平：治疗性IV级。
