近端指间关节过度伸展损伤的管理：一项随机对照试验。
Management of proximal interphalangeal joint hyperextension injuries: a randomized controlled trial.
作者信息
Paschos Nikolaos K, Abuhemoud Khaled, Gantsos Apostolos, Mitsionis Grigorios I, Georgoulis Anastasios D
机构信息
Department of Trauma and Orthopaedic Surgery, University of Ioannina, Greece; Department of Biomedical Engineering and Orthopaedic Surgery, University of California, Davis, California.
Department of Trauma and Orthopaedic Surgery, University of Ioannina, Greece; Department of Biomedical Engineering and Orthopaedic Surgery, University of California, Davis, California.
出版信息
J Hand Surg Am. 2014 Mar;39(3):449-54. doi: 10.1016/j.jhsa.2013.11.038. Epub 2014 Feb 4.
PURPOSE
To compare the effectiveness of buddy strapping and aluminum orthosis for treatment of proximal interphalangeal (PIP) joint hyperextension injuries. We also evaluated the effect of age on the outcome by comparing our results in adults and children.
METHODS
One hundred twenty-one consecutive patients with a PIP joint hyperextension injury of the index, middle, ring, or little finger and without fracture were evaluated. Patients were randomly assigned into 2 groups. In the first group, treatment included buddy strapping of the injured finger to its neighbor noninjured finger for a week. In the second group, immobilization was secured with an aluminum extension blocking orthosis for a week in 15° flexion. Assessment of motion, edema, pain, and strength were performed weekly for the first month and then at 3, 6, and 12 months after injury.
RESULTS
The patients treated with buddy strapping exhibited similar outcomes compared with those treated with aluminum orthoses. In patients with full recovery, buddy strapping allowed earlier recovery of motion and resolution of edema and pain compared with aluminum orthosis immobilization. Furthermore, PIP injuries appear to have better outcomes in children than in adults.
CONCLUSIONS
Buddy strapping is easy and effective treatment for PIP joint hyperextension injuries.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic I.
目的
比较搭扣绑扎与铝制矫形器治疗近端指间（PIP）关节过度伸展损伤的效果。我们还通过比较成人和儿童的结果，评估年龄对治疗结果的影响。
方法
对121例连续的示指、中指、环指或小指PIP关节过度伸展损伤且无骨折的患者进行评估。患者被随机分为两组。第一组的治疗方法是将受伤手指与相邻未受伤手指用搭扣绑扎一周。第二组使用铝制伸展阻挡矫形器在15°屈曲位固定一周。在伤后的第一个月每周进行一次活动度、水肿、疼痛和力量的评估，然后在伤后3个月、6个月和12个月进行评估。
结果
与使用铝制矫形器治疗的患者相比，使用搭扣绑扎治疗的患者表现出相似的结果。在完全恢复的患者中，与铝制矫形器固定相比，搭扣绑扎能使活动度更早恢复，水肿和疼痛更快消退。此外，PIP损伤在儿童中的治疗效果似乎比成人更好。
结论
搭扣绑扎是治疗PIP关节过度伸展损伤的一种简便有效的方法。
研究类型/证据水平：治疗性研究I级
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