The Importance of Active Exercise in Treatment of Tendinous Mallet Finger: Insights From a Randomized Controlled Clinical Trial.

IF 2.1 2区 医学 Q2 ORTHOPEDICS
Xuwei Zhu, Ximiao Chen, Ya Lv, Yiheng Chen, Weiyang Gao, Hede Yan
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引用次数: 0

Abstract

Purpose: Tendinous mallet finger lacks high-level evidence guiding optimal treatment. In this study, we compared the results of thermoplastic splints with those of surgical treatment using Kirschner wire (K-wire) fixation in the management of tendinous mallet finger injuries.

Method: Forty-eight patients were enrolled and randomly assigned to the thermoplastic splint group (n = 23) and K-wire group (n = 25). An evaluation was performed 16 weeks after treatment, mainly focusing on DIP joint extension and flexion angles, and extension lag. The results were graded using the Abouna-Brown and Crawford scores, and factors affecting the outcomes were analyzed.

Results: There was no significant difference in the outcomes between the groups in terms of final extension and extension lag after 16 weeks. The final extension of the DIP joint in both groups correlated with the extension degree under fixation (R = 0.60) and the maximal extension of the contralateral fingers (Rho = 0.54). Slight extension loss was observed in the early stage after the removal of the form of immobilization (K-wires or splints), which was partially improved by routine active exercise.

Conclusions: Both K-wire fixation and thermoplastic splinting are effective treatments for tendinous mallet fingers, showing similar patterns of DIP joint extension loss and recovery during rehabilitation. Sustained active exercise appears to support DIP joint extension recovery.

Type of study/level of evidence: Therapeutic II.

积极运动在治疗锤状指肌腱中的重要性:来自随机对照临床试验的见解。
目的:肌腱锤状指缺乏指导最佳治疗的高水平证据。在本研究中,我们比较了热塑性夹板与克氏针(k -丝)固定治疗锤状指肌腱损伤的结果。方法:48例患者随机分为热塑性夹板组(23例)和k线组(25例)。治疗16周后进行评估,主要关注DIP关节的伸屈角度和伸屈滞后。使用Abouna-Brown和Crawford评分对结果进行评分,并分析影响结果的因素。结果:两组患者在16周后的最终延长时间和延长延迟时间方面无显著差异。两组DIP关节的最终伸度与固定下伸度(R = 0.60)和对侧手指最大伸度(Rho = 0.54)相关。在移除固定物(克氏针或夹板)后的早期阶段观察到轻微的伸展丧失,通过常规的积极运动可以部分改善。结论:k线固定和热塑性夹板均是治疗锤状指的有效方法,在康复过程中DIP关节伸展丧失和恢复模式相似。持续的积极运动似乎支持DIP关节伸展恢复。研究类型/证据水平:治疗性II。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.20
自引率
10.50%
发文量
402
审稿时长
12 weeks
期刊介绍: The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.
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