Lee Seoung Joon, Lee Jun Hee, Hwang In Cheul, Kim Joon Kuk, Lee Jung Il
Department of Orthopedic Surgery, School of Medicine, Konkuk University Medical Center, Seoul, South Korea.
Department of Orthopedic Surgery, Hanyang University Guri Hospital, Guri, South Korea.
Acta Orthop Traumatol Turc. 2017 Jan;51(1):44-48. doi: 10.1016/j.aott.2016.12.002. Epub 2016 Dec 18.
The purpose of this study was to compare the outcomes of non-operative treatment and operative repair of grade III injuries with complete rupture of the collateral ligament of the proximal interphalangeal (PIP) joint.
Seventeen patients with grade III injuries with at least 6 months of follow-up were included. Seven patients underwent non-operative treatment and 10 patients underwent operative treatment. We evaluated the following clinical outcomes after treatment: 1) range of motion of the PIP and distal interphalangeal (DIP) joints, 2) joint stability, 3) pain score, and 4) amount of fusiform deformity of the PIP joint.
There was no instability in the lateral stress test in either group. The ranges of motion of the PIP and DIP joints were not statistically different between the two groups at final follow-up. However, the ranges of motion recovered more quickly in the operative group than the non-operative group within the first 3 months after treatment. Patients in the operative group had less pain and better cosmetic appearance of the PIP joint.
Our results suggest that operative repair of the PIP collateral ligament can provide good joint stability, rapid functional recovery, and minimize fusiform deformity of the PIP joint.
Level III, Therapeutic study.
本研究旨在比较近端指间关节（PIP）侧副韧带完全断裂的Ⅲ级损伤的非手术治疗和手术修复的效果。
纳入17例至少随访6个月的Ⅲ级损伤患者。7例患者接受非手术治疗，10例患者接受手术治疗。我们评估了治疗后的以下临床结果：1）PIP和远端指间关节（DIP）的活动范围，2）关节稳定性，3）疼痛评分，以及4）PIP关节的梭形畸形程度。
两组的侧方应力试验均无不稳定情况。最终随访时，两组之间PIP和DIP关节的活动范围无统计学差异。然而，治疗后前3个月内，手术组的活动范围恢复比非手术组更快。手术组患者的疼痛较轻，PIP关节的外观更好。
我们的结果表明，PIP侧副韧带的手术修复可提供良好的关节稳定性、快速的功能恢复，并使PIP关节的梭形畸形最小化。
Ⅲ级，治疗性研究。
