Papatolicas Kelly A, Clingin Jessica E, Nicks Rebecca J
Maroondah Hospital, Eastern Health, Ringwood, Victoria, Australia; Box Hill Hospital, Eastern Health, Box Hill, Victoria, Australia.
Maroondah Hospital, Eastern Health, Ringwood, Victoria, Australia; Box Hill Hospital, Eastern Health, Box Hill, Victoria, Australia.
J Hand Ther. 2025 Jan-Mar;38(1):91-96. doi: 10.1016/j.jht.2024.06.002. Epub 2024 Aug 31.
Injuries to the proximal interphalangeal joint (PIPJ) of the fingers are commonly treated in hand therapy departments. Conservative management for PIPJ volar plate injuries typically involves a dorsal blocking orthosis and flexion exercises. Historically hand therapists have placed the PIPJ in varying degrees of flexion but the optimal angle is unknown.
To compare the outcomes of two treatment groups who received dorsal blocking orthoses: Those who the orthosis was positioned in neutral compared to those in 25-30° of flexion.
Retrospective cohort study.
Patients treated by the hand therapy service at a major metropolitan hospital network in Melbourne, Australia, for conservative management of a PIPJ volar plate injury over a three-year period were included in our study. Data regarding patient demographics, digits affected and injury type were collected. Outcomes included presence of a fixed flexion deformity (FFD), amount of hand therapy received and total active flexion at the PIPJ.
One hundred and eleven participants were included in our study. The mean age was 26 and 59 (53%) were males. Seventy two (64%) participants received a dorsal blocking orthosis positioned in neutral and 39 (35%) were positioned in 25-30° flexion at the PIPJ. Participants whose orthosis was positioned at 25-30° had an average of 24 more minutes in hand therapy (which equates to approximately one appointment) compared to those whose PIPJ was positioned in neutral (p=0.006, d=0.5). Eight percent less participants developed a FFD (p = 0.24) and 13% more participants achieved full flexion (p = 0.06) in the group who received a dorsal blocking orthosis in neutral, however these results were not statistically significant.
PIPJ volar plate injures treated in an orthosis positioned in neutral required fewer hand therapy appointments. There was no statistically significant difference between groups regarding development of a FFD or full flexion.
手指近端指间关节（PIPJ）损伤常在手部治疗科室进行治疗。PIPJ掌板损伤的保守治疗通常包括背侧阻挡支具和屈曲练习。过去，手部治疗师将PIPJ置于不同程度的屈曲位，但最佳角度尚不清楚。
比较接受背侧阻挡支具治疗的两个治疗组的结果：支具处于中立位的患者与处于25 - 30°屈曲位的患者。
回顾性队列研究。
纳入澳大利亚墨尔本一个大型都市医院网络的手部治疗服务部门在三年期间因PIPJ掌板损伤接受保守治疗的患者。收集有关患者人口统计学、受累手指和损伤类型的数据。结果包括固定性屈曲畸形（FFD）的存在、接受手部治疗的次数以及PIPJ的总主动屈曲度。
本研究纳入了111名参与者。平均年龄为26岁，59名（53%）为男性。72名（64%）参与者接受了处于中立位的背侧阻挡支具，39名（35%）参与者的PIPJ处于25 - 30°屈曲位。与PIPJ处于中立位的参与者相比，PIPJ处于25 - 30°屈曲位的参与者平均多接受24分钟的手部治疗（相当于约一次治疗预约）（p = 0.006，d = 0.5）。接受中立位背侧阻挡支具的组中，发生FFD的参与者少8%（p = 0.24），实现完全屈曲的参与者多13%（p = 0.06），然而这些结果无统计学意义。
使用处于中立位的支具治疗PIPJ掌板损伤所需的手部治疗预约次数更少。两组在FFD发生或完全屈曲方面无统计学显著差异。
