Dorsal dislocations or hyperextension injuries with a volar plate avulsion of the proximal interphalangeal joint, conservative treatment with or without supervised hand-therapy?

Completed

Conditions: Pees, -ligamentair letsel
Dislocation of the finger
hyperextension injury of the finger
10017322
10005944

Registration Number: NL-OMON55623

Lead Sponsor: OLVG

Brief Summary: Not available

Detailed Description: Not available

Recruitment & Eligibility

Status: Completed

Sex: Not specified

Target Recruitment: 222

Inclusion Criteria

- All adult patients with a PIP hyperextension injury leading to a complete
dorsal dislocation, objectified by a doctor at the emergency department or by
radiograph at the emergency department.
- All adult patients with PIP hyperextension injury leading to a volar plate
avulsion, objectified by an avulsion fracture of the proximal volar part of the
mid phalanx (< 40% of the joint) on a radiograph at the emergency department. -
Patients >=18 years
- Single PIP hyperextension injuries or dislocation of the fingers
- A stable joint after reduction, assessed by dorsal, volar, and lateral stress
on the PIP joint in extension and 30 degrees of PIP flexion.
- Standard conservative treatment with a dorsal block splint in 0 degrees
extension for four weeks.
- Avulsion fracture of the proximal volar part of the mid phalanx (< 40% of the
joint)* on a radiograph at the emergency department .
- Standardized Eaton classification: type I,II,IIIaslocat

Exclusion Criteria

- An avulsion fracture of the PIP joint, >40% of the articular surface
- Re-displacement during digit motion
- An unstable joint after reduction assessed by dorsal, volar, and lateral
stress on the PIP joint, requiring operative treatment
- Irreducible dislocations
- Suspicion for interposition of the volar plate
- Operation indication
- Hyperextension injuries of the IP of the thumb
- Multiple PIP hyperextension injuries or dislocation of the fingers
- Patients with impaired hand function prior to injury due to
arthrosis/neurological disorders of the upper limb
- Multiple trauma patients (Injury Severity Score (ISS) >=16)
- Other injuries in the ipsilateral extremity
- Insufficient comprehension of the Dutch language to understand a
rehabilitation program and other treatment information as judged by the
attending physician
- Patients suffering from disorders of bone metabolism other than osteoporosis
(i.e. Paget*s disease, renal osteodystrophy, osteomalacia
- Patients suffering from connective tissue disease or (joint)
hyper-flexibility disorders such as Marfan*s, Ehler Danlos or other related
disorders.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
<p>Function, pain and disability expressed as change on the Michigan Hand<br /><br>Questionnaire Score (MHQ) after three months. The MHQ is a validated tool for<br /><br>assessing functional outcome in patients with complaints of the hand5,9. The<br /><br>MHQ is a questionnaire divided in six subscales; overall hand function,<br /><br>activities of daily living (ADLs), pain, work performance, aesthetics and<br /><br>patient satisfaction with hand function. Each subscale has a formula to<br /><br>calculate a score from 0 (severe disability) to 100 (no disability). The final<br /><br>score is a summation of the six individual item-scores divided by six and<br /><br>ranges from 0 (severe disability) to 100 (no disability).</p><br>

Secondary Outcome Measures