Hou Xin Ju, Ng Ying Jing, Yu Qing Ying, Lin Xing Zhen, Han Ray P S
Jiangxi University of Chinese Medicine, Nanchang, 330004, Jiangxi, China.
Department of Rehabilitation, Nanchang Hongdu Hospital of TCM, Nanchang, Jiangxi Province, China.
J Orthop Surg Res. 2025 May 21;20(1):494. doi: 10.1186/s13018-025-05893-y.
Finger joint stiffness is a common post-treatment complication in patients with upper limb fractures that lowers their quality of life. Physiotherapy is the standard of care for functional restoration in patients with finger joint stiffness. However, in adult patients, physiotherapy alone is not always sufficient to restore joint function. In this study, we report the efficacy of ultrasound-guided capsular hydrodilatation in adult patients with post-trauma finger joint stiffness that did not improve after ≥ 2 weeks of conventional physiotherapy.
This prospective study included adult patients who developed finger joint stiffness after conservative treatment with plaster of Paris or open reduction and internal fixation for upper limb injuries between March 2023 and June 2024. All patients underwent ultrasound-guided hydrostatic separation of the finger joint capsules followed by conventional finger joint exercises. The outcomes of treatment were evaluated two weeks post-treatment.
A total of 15 patients with an average age of 58.13 ± 17.64 years were included in this study. The mean pain score decreased from 6.4 ± 1.06 cm to 1.93 ± 0.70 cm respectively (p < 0.0001) at baseline and 2 weeks post-treatment. The median joint swelling score decreased from 2 at baseline to 0 at 2 weeks post-treatment (p < 0.0001). The active ranges of motion increased by 51 ± 4.48 degrees, 18.27 ± 4.62 degrees, and 29.73 ± 4.79 degrees for the MCP, PIP, and DIP joints, respectively. Similarly, the passive ranges of motion increased by 43.4 ± 4.72, 13.27 ± 5.73 degrees, and 26.73 ± 4.83 degrees for the MCP, PIP, and DIP joints, respectively.
Ultrasound-guided capsular hydrodilatation in combination with conventional finger joint exercises is an effective intervention for post-trauma finger joint stiffness that is refractory to conventional physiotherapy in adult patients. It is a relatively simple and minimally invasive procedure that can rapidly reduce pain, and swelling, and restore finger joint function.
手指关节僵硬是上肢骨折患者常见的治疗后并发症，会降低患者生活质量。物理治疗是手指关节僵硬患者功能恢复的标准治疗方法。然而，对于成年患者，仅靠物理治疗并不总能恢复关节功能。在本研究中，我们报告了超声引导下关节囊液压扩张术对成年创伤后手指关节僵硬患者的疗效，这些患者在接受≥2周的传统物理治疗后未见改善。
这项前瞻性研究纳入了2023年3月至2024年6月期间因上肢损伤接受石膏保守治疗或切开复位内固定后出现手指关节僵硬的成年患者。所有患者均接受了超声引导下手指关节囊的液压分离，随后进行传统的手指关节锻炼。在治疗后两周评估治疗效果。
本研究共纳入15例患者，平均年龄58.13±17.64岁。基线时平均疼痛评分分别为6.4±1.06cm，治疗后2周降至1.93±0.70cm（p<0.0001）。中位关节肿胀评分从基线时的2分降至治疗后2周的0分（p<0.0001）。掌指关节、近端指间关节和远端指间关节的主动活动范围分别增加了51±4.48度、18.27±4.62度和29.73±4.79度。同样，掌指关节、近端指间关节和远端指间关节的被动活动范围分别增加了43.4±4.72度、13.27±5.73度和26.73±4.83度。
超声引导下关节囊液压扩张术联合传统手指关节锻炼是治疗成年患者创伤后手指关节僵硬的有效干预措施，这类僵硬对传统物理治疗无效。这是一种相对简单且微创的手术，可迅速减轻疼痛和肿胀，并恢复手指关节功能。
