Outpatient Rehabilitation Services, Bendigo Health Care Group, Victoria, Australia; Research and Innovation, Bendigo Health Care Group, Victoria, Australia.
Rural Health School, La Trobe University, Victoria, Australia; Holsworth Research Initiative, La Trobe Rural Health School, Bendigo, Victoria.
J Hand Ther. 2024 Jul-Sep;37(3):363-370. doi: 10.1016/j.jht.2023.11.001. Epub 2024 Feb 15.
Volar plate injuries of the proximal interphalangeal (PIP) finger joint are common. Conservative treatment involves orthoses to limit hyperextension at the PIP joint yet allow movement of the joints to prevent joint stiffness and deformity. Custom-made dorsal blocking orthoses are recommended treatments. Previous research also supports the use of a figure-of-8 orthosis, although the comparative effectiveness of these orthoses is not currently known.
This study aimed to compare the figure-of-8 orthosis and dorsal blocking orthosis for changes in the range of movement, pain, and function following stable volar plate PIP joint injuries and to compare the number of hand therapy appointments required.
A parallel-group pilot randomized controlled trial. This trial was registered with the Australian and New Zealand Clinical Trials Registry (Trial ID: CTRN12619000449134).
Participants aged 13-65 years were recruited from an outpatient hand therapy service and randomly assigned to experimental or control groups. The experimental group of 20 participants received a custom-made thermoplastic figure-of-8 orthosis limiting the extension to 15-20 degrees. The control group of 22 participants had a dorsal blocking orthosis, which was serially extended by 10 degrees weekly starting at 30 degrees flexion. Participants were blinded to their group allocation. Outcome measures included range of movement, edema, pain, function, and number of hand therapy appointments. Data collection was completed by the treating therapist who was not blinded to group assignment. Data analysis included a series of mixed-model analyses of variance to examine changes over time.
Forty-two participants were recruited and had their data analyzed. No significant between-group differences were observed for DIP flexion, PIP flexion, pain, and function from baseline to follow-up. Both groups exhibited significant improvements in these outcomes over time (p < 0.001); effect sizes ranged from small to large (0.28-0.79). On average, the intervention group required 4 (±1.5) appointments compared to 6 (±1.5) in the control group over the same period representing a significant difference (p < 0.001).
Both dorsal blocking and figure-of-8 orthoses provide similar outcomes. The use of a figure-of-8 orthosis, or a dorsal block orthosis fabricated in maximal comfortable extension depending on severity, could reduce the number of appointments and increase convenience for patients.
近节指间关节（PIP）掌侧板损伤较为常见。保守治疗包括矫形器以限制 PIP 关节过度伸展，同时允许关节活动以防止关节僵硬和畸形。定制背侧阻挡矫形器是推荐的治疗方法。先前的研究也支持使用 8 字形矫形器，尽管目前尚不清楚这些矫形器的相对有效性。
本研究旨在比较 8 字形矫形器和背侧阻挡矫形器治疗稳定掌侧板 PIP 关节损伤后活动范围、疼痛和功能的变化，并比较所需的手部治疗预约次数。
平行组随机对照试验。该试验在澳大利亚和新西兰临床试验注册中心（试验 ID：CTRN12619000449134）注册。
从门诊手治疗服务中招募年龄在 13-65 岁的参与者，并将其随机分配到实验组或对照组。实验组 20 名参与者接受定制热塑 8 字形矫形器，限制伸展至 15-20 度。对照组 22 名参与者使用背侧阻挡矫形器，每周增加 10 度，从 30 度屈曲开始。参与者对其分组分配不知情。主要结局包括活动范围、肿胀、疼痛、功能和手部治疗预约次数。数据收集由未对分组分配不知情的治疗师完成。数据分析包括一系列混合模型方差分析，以检查随时间的变化。
共招募了 42 名参与者并对其数据进行了分析。从基线到随访，DIP 屈曲、PIP 屈曲、疼痛和功能在两组之间均无显著差异。两组在这些结局上均随时间显著改善（p<0.001）；效应大小范围从小到大（0.28-0.79）。平均而言，干预组在同一时期需要 4（±1.5）次预约，而对照组需要 6（±1.5）次预约，差异有统计学意义（p<0.001）。
背侧阻挡和 8 字形矫形器均提供相似的结果。使用 8 字形矫形器或根据严重程度制作的最大舒适伸展背侧阻挡矫形器可减少预约次数并提高患者的便利性。
