掌板修复治疗慢性损伤

Q3 Medicine

Journal of Hand Surgery Global Online Pub Date : 2025-07-23 DOI:10.1016/j.jhsg.2025.100776

Michael Buldo-Licciardi MD , Marshall L. Balk MD , Robert J. Goitz MD

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引用次数: 0

摘要

目的本研究的目的是评估掌侧钢板修复慢性损伤的长期疗效。方法纳入在初始损伤后超过6个月接受掌侧板修复的慢性不稳定患者。术后至少随访2年。结果测量包括活动范围、上肢QuickDASH（手臂、肩膀和手的残疾）评分、恢复工作、恢复运动和x线平片。结果纳入10例患者。从损伤到修复的平均时间为9年，10个月至30年不等。涉及的手指包括一个拇指，四个无名指和五个小指。其中9人表示非常满意，1人表示对最终随访结果满意。十分之九的人报告疼痛是他们最初的症状，在最后的随访中没有人报告疼痛。术前所有患者均有近端指间过伸，范围为15°~ 60°，其中3例为天鹅颈畸形。在最后的随访中，9例患者的关节伸度从0°到3°不等。此外，1例患者发生过伸25°，尽管该患者随后发生损伤。所有患者在最后随访时均有近端指间关节完全屈曲。手术前报告有职业障碍的三名受试者在手术后没有功能限制。两名受伤导致运动受限的受试者报告恢复到受伤前的运动水平。结论从满意度、QuickDASH评分、体格检查和影像学检查结果来看，掌侧钢板修复治疗慢性损伤是成功的。这些好处在受伤后几十年进行的修复中被注意到。研究类型/证据水平治疗性IV。

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Volar Plate Repair for Chronic Injury

Purpose

The aim of this study was to assess the long-term outcomes of volar plate repair for chronic injury.

Methods

Patients who underwent volar plate repair for chronic instability more than 6 months following the initial injury were included. A minimum follow-up of 2 years from time of surgery was required. Outcome measures included range of motion, the upper extremity QuickDASH (Disabilities of the Arm, Shoulder, and Hand) score, return to work, return to sport, and plain radiographs.

Results

Ten patients were included. The mean time from injury to repair was 9 years, ranging from 10 months to 30 years. The digits involved included one thumb, four ring fingers, and five small fingers. Nine reported being extremely satisfied, and one reported being satisfied with their outcome at final follow-up. Nine of ten reported pain as their initial symptom, and none reported pain at final follow-up. Prior to surgery, all patients had proximal interphalangeal hyperextension ranging from 15° to 60°, three of which were classified as swan neck deformities. At final follow-up, nine patients had extension ranging from 0° to 3°. In addition, one patient had a hyperextension of 25°, although this patient had a subsequent injury. All had full flexion of their proximal interphalangeal joint at final follow-up. The three subjects who reported occupational impairment prior to surgery had no functional limitations following surgery. Two subjects whose injuries led to sport limitations reported returning to their preinjury level of sport.

Conclusions

Volar plate repair for chronic injury resulted in successful outcomes based on satisfaction, QuickDASH score, physical examination, and radiographic images. These benefits were noted in a repairs performed decades after injury.