Caviglia Daniele, Ciolli Gianluca, Fulchignoni Camillo, Rocchi Lorenzo
Orthopaedics and Hand Surgery Unit, Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome; Università Cattolica del Sacro Cuore, Rome, Italy.
Orthop Rev (Pavia). 2021 Mar 31;13(1):9058. doi: 10.4081/or.2021.9058. eCollection 2021 Mar 30.
Avulsions of the volar plate of the finger proximal interphalangeal joint (PIPJ) following sprains are often undiagnosed in the acute setting. Therefore, the chronic outcomes of this injury are most frequently the object of study and treatment. Different techniques for volar plate chronic avulsion repair are described in the literature. The most used among these are mainly two: the direct suturing with or without the use of bone anchors and the tenodesis techniques with flexor digitalis superficialis (FDS). The aim of this systematic review is to determine outcomes and complications associated with these surgical treatments of post-traumatic volar plate avulsions without phalangeal fractures. An electronic literature research was carried out and pertinent articles were selected. Surgical techniques details, outcomes and complications for direct sutures and tenodesis technique are discussed. Outcomes (Range of motion and pain) seem to be comparable, whereas authors that use the direct suture technique describe more frequently PIPJ flexion contracture complication. From this review of the literature, authors believe that both techniques are available for the repair of chronic injuries of the volar plate of the PIPJ, although direct suturing can be considered as less reproducible.
手指近端指间关节（PIPJ）掌侧板在扭伤后发生的撕脱伤在急性情况下常未被诊断出来。因此，这种损伤的慢性后果最常成为研究和治疗的对象。文献中描述了掌侧板慢性撕脱伤修复的不同技术。其中最常用的主要有两种：使用或不使用骨锚的直接缝合以及指浅屈肌（FDS）的腱固定技术。本系统评价的目的是确定这些治疗创伤后掌侧板撕脱伤且无指骨骨折的手术治疗相关的结果和并发症。进行了电子文献检索并选择了相关文章。讨论了直接缝合和腱固定技术的手术技术细节、结果和并发症。结果（活动范围和疼痛）似乎具有可比性，而使用直接缝合技术的作者更频繁地描述了PIPJ屈曲挛缩并发症。从这篇文献综述来看，作者认为这两种技术都可用于修复PIPJ掌侧板的慢性损伤，尽管直接缝合的可重复性可能较低。
