Jefferson Health Orthopaedic Surgery Residency - New Jersey, Stratford, NJ.
Reconstructive Orthopaedics, Sewell, NJ.
J Hand Surg Am. 2024 Nov;49(11):1138.e1-1138.e6. doi: 10.1016/j.jhsa.2023.01.025. Epub 2023 Apr 1.
Proximal interphalangeal (PIP) joint sprains are common injuries that often result in prolonged swelling, stiffness, and dysfunction; however, the duration of these sequelae is unknown. The purpose of this study was to determine the duration of time that patients experience finger swelling, stiffness, and dysfunction following a PIP joint sprain.
This was a prospective, longitudinal, survey-based study. To identify patients with PIP joint sprains, the electronic medical record was queried monthly using International Classification of Disease, Tenth Revision, codes for PIP joint sprain. A five-question survey was emailed monthly for 1 year or until their response indicated resolution of swelling, whichever occurred sooner. Two cohorts were established: patients with (resolution cohort) and patients without (no-resolution cohort) self-reported resolution of swelling of the involved finger within 1 year of a PIP joint sprain injury. The measured outcomes included self-reported resolution of swelling, self-reported limitations to range of motion, limitations to activities of daily living, Visual Analog Scale (VAS) pain score, and return to normalcy.
Of 93 patients, 59 (63%) had complete resolution of swelling within 1 year of a PIP joint sprain. Of the patients in the resolution cohort, 42% reported return to subjective normalcy, with 47% having self-reported limitations in range of motion and 41% having limitations in activities of daily living. At the time of resolution of swelling, the average VAS pain score was 0.8 out of 10. In contrast, only 15% of patients in the no-resolution cohort reported return to subjective normalcy, with 82% having self-reported limitations in range of motion and 65% having limitations in activities of daily living. For this cohort, the average VAS pain score at 1 year was 2.6 out of 10.
It is common for patients to experience a prolonged duration of swelling, stiffness, and dysfunction following PIP joint sprains.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic IV.
近节指间关节（PIP）扭伤是常见的损伤，常导致长时间肿胀、僵硬和功能障碍；然而，这些后遗症的持续时间尚不清楚。本研究的目的是确定患者在 PIP 关节扭伤后经历手指肿胀、僵硬和功能障碍的时间。
这是一项前瞻性、纵向、基于调查的研究。为了确定 PIP 关节扭伤患者，每月使用国际疾病分类，第十版 PIP 关节扭伤代码对电子病历进行查询。在 1 年内或直到他们的回复表明肿胀已解决（以先发生者为准），每月通过电子邮件发送 5 个问题的调查。建立了两个队列：在 1 年内自我报告 PIP 关节扭伤损伤的受累手指肿胀已解决（解决队列）和未自我报告肿胀已解决（未解决队列）的患者。测量结果包括自我报告肿胀的解决情况、自我报告运动范围受限情况、日常生活活动受限情况、视觉模拟量表（VAS）疼痛评分和恢复正常情况。
93 例患者中，59 例（63%）在 PIP 关节扭伤后 1 年内完全消肿。在解决队列的患者中，42%报告恢复主观正常，47%有运动范围的自我报告受限，41%有日常生活活动受限。在肿胀解决时，平均 VAS 疼痛评分为 10 分中的 0.8 分。相比之下，仅 15%的未解决队列患者报告恢复主观正常，82%有运动范围的自我报告受限，65%有日常生活活动受限。对于该队列，1 年时的平均 VAS 疼痛评分为 10 分中的 2.6 分。
患者在 PIP 关节扭伤后常经历长时间的肿胀、僵硬和功能障碍。
研究类型/证据水平：预后 IV。
