Carr S, O'Donoghue P J, Bowe A, O'Ceallaigh B, Siney E, Kelly J L
Department Plastic & Reconstructive Surgery Galway University Hospital, GUH.
Department of Hand Therapy Galway University Hospital, GUH.
JPRAS Open. 2023 Jun 2;37:163-170. doi: 10.1016/j.jpra.2023.05.004. eCollection 2023 Sep.
Central slip disruption may lead to PIP joint dysfunction causing significant morbidity. Existing evidence for any specific surgical management of these injuries is limited but does favor early mobilization of the PIP joint. To assess the functional outcome in a cohort of patients undergoing central slip repair with internal K-wire proximal interphalangeal joint splinting and complete immobilization against those with external splinting only. A single center retrospective analysis of all patients that underwent operative central slip repair in our institution over a 5-year period. Data were collected via the HIPE database and clinical notes. Data relating to demographics as well as range of motion, total active motion {(TAM) (TAM%)} score, and hand therapy rehabilitation type were analyzed. The study population was n = 44 patients. N = 33 patients were treated without a K-wire and n = 11 treated with a K-wire. There was a male predominance, 81.8% (n = 36). Mean age was 40.4 years. There was no significant difference in the mean TAM achieved at final measurement between the "no K-wire" and the "K-wire" treatment groups [no K-wire 202.1° (standard deviations (SD) 40.0) vs. K-wire 187.4° (SD 28.2), p = 0.208]. The "no K-wire group" achieved a mean TAM % of 78.0 (SD 11.4) and the "K-wire group" achieved a mean TAM % of 72.1 (SD 10.8); no statistically significant difference in mean scores was observed between groups. : Our study has shown comparable functional outcomes between those having complete joint immobilization with internal K-wire splinting and those that are externally splinted only following central slip repair.
中央束断裂可能导致近端指间关节功能障碍,引发严重疾病。目前关于这些损伤的任何特定手术治疗的证据有限,但确实支持近端指间关节的早期活动。为了评估一组接受中央束修复并采用克氏针近端指间关节内固定和完全固定的患者与仅采用外固定的患者的功能结局。对本机构在5年期间接受中央束手术修复的所有患者进行单中心回顾性分析。通过HIPE数据库和临床记录收集数据。分析了与人口统计学以及活动范围、总主动活动度{(TAM)(TAM%)}评分和手部治疗康复类型相关的数据。研究人群为44例患者。33例患者未使用克氏针治疗,11例患者使用了克氏针治疗。男性占主导,为81.8%(n = 36)。平均年龄为40.4岁。“无克氏针”治疗组和“克氏针”治疗组在最终测量时达到的平均TAM之间无显著差异[无克氏针组为202.1°(标准差(SD)40.0),克氏针组为187.4°(SD 28.2),p = 0.208]。“无克氏针组”的平均TAM%为78.0(SD 11.4),“克氏针组”的平均TAM%为72.1(SD 10.8);两组之间平均评分无统计学显著差异。我们的研究表明,在中央束修复后,采用克氏针内固定完全固定关节的患者与仅采用外固定患者的功能结局相当。