近端指间关节副韧带完全断裂未能保存的手术修复的临床效果

Young Hwan Kim
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摘要

目的:本研究的目的是比较手术治疗未能保存近端指间关节(PIP)副韧带完全断裂的患者的术前和术后结果。方法:对保守治疗4周后出现症状的患者,由放射科医师用超声或磁共振成像确诊为副韧带完全断裂。11例患者行手术侧副韧带固定修复术。所有患者术后随访至少6个月。我们评估了术前和随访6个月的临床结果:(1)PIP的活动范围,(2)关节稳定性,(3)视觉模拟量表评分,(4)PIP关节的梭状指数,(5)功能和美容满意度。结果:随访6个月,侧应力试验无不稳定性。术前和6个月随访时,PIP的活动范围无统计学差异。患者疼痛减轻,但PIP关节的外观没有改善。功能满意度有统计学差异,但外观满意度无统计学差异。结论:手术治疗PIP关节副韧带完全断裂未能保存的患者可提供良好的关节稳定性和功能恢复。
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Clinical Outcomes of Operative Repair for Patients Who Fail to Conserve the Complete Rupture of the Collateral Ligament in the Proximal Interphalangeal Joint
Objective: The purpose of this study was to compare the preoperative and postoperative outcomes of surgical treatment for patients who fail to conserve the complete rupture of the collateral ligament in the proximal interphalangeal (PIP) joint.Methods: A complete rupture of the collateral ligament was confirmed by a radiologist using ultrasound or magnetic resonance imaging for patients who had symptoms after 4 weeks of conservative treatment. Eleven patients underwent operative collateral ligament repair using an anchor. All patient was followed up for at least 6 months postoperatively. We evaluated clinical outcomes preoperatively and at 6 months follow-up: (1) range of motion of the PIP, (2) joint stability, (3) Visual Analog Scale score, (4) fusiform index of the PIP joint, and (5) functional & cosmetic satisfaction.Results: There was no instability in the lateral stress test at 6-month follow-up. The ranges of motion of the PIP were not statistically different between preoperative and at 6-month follow-up. Patients had less pain but the cosmetic appearance of the PIP joint did not improve. Functional satisfaction differed statistically, but there was no difference in cosmetic satisfaction.Conclusion: Surgical treatment for patients who fail to conserve the complete rupture of the collateral ligament in the PIP joint can provide good joint stability, functional recovery.
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