Frühfunktionelles Management bei Hyperextensionstraumata des proximalen Interphalangealgelenkes mit Läsion der palmaren Platte: Extensionsblock versus Achterschlaufe

Abstract

Volar plate disruption of the proximal interphalangeal joint (PIP) is a common hand injury following finger hyperextension. At our institution, patients presenting with disruptions of the palmar plate (Eaton and Littler types I and II) before 2011 were treated with extension block splinting (group A). Since 2011, all patients with Eaton and Littler types I and II have received buddy taping (group B). The aim of this retrospective study was to compare the respective treatment outcomes. In this retrospective study, we analysed the data of 44 patients visiting our department with volar plate disruption (Eaton and Littler types I and II) from 2009 to 2012. In group A, 23 patients were treated with custom-made extension block splinting in 10 ° flexion, compared with 21 patients treated with buddy taping in group B. Both groups received dorsal night splinting in 10 ° flexion. No statistically significant differences between the two groups were found in regard to treatment duration (p = 0,981), amount of required treatment sessions (p = 0,271), total active motion (TAM) (p = 0,693) and extension deficit (p = 0,404) in the PIP joint at the end of treatment, time until hand therapy was started (p = 0,285) or the Eaton und Littler diagnosis (p = 0,241). In the extension block group (group A), 10 out of 23 (44 %) patients after a median of 9 (4-10) weeks of treatment had an excellent result, 11 (48 %) had a good result, and 2 (8 %) patients had a poor result with a median 90 ° (85-100 °) TAM in the PIP joint and no extension deficit. In group A, all patients received a median of 4 (3-6) treatment sessions. Of those treated with buddy taping (group B), 14 out of 21 (66 %) patients at a median of 6 (4-13) weeks had an excellent result, 6 (29 %) had a good result, and 1 (5 %) patient had a poor result with a median TAM of 95 ° (82,5-100 °) and no extension deficit. In this group, patients received a total of 4 (3-5) treatment sessions. The type of treatment had no significant influence on the Benke and Stableforth outcome (χ2 = 2,385, df = 3, p = 0,304). No patient developed palmar joint instability. No treatment option proved to be superior. We consider buddy taping to be faster, easier and more flexible to use.

HaMiPla Best Paper Sitzungen – Ihre Favoriten 2017

“…Lukas Lunger, München, stellte seine Arbeit "Frühfunktionelles Management bei Hyperextensionstraumata des proximalen Interphalangealgelenkes" vor [9], in der er zusammen mit seinem Bruder Alexander Lunger die Behandlung mittels Extensionsblockschiene und mittels Achterschlaufe (Buddy Taping) miteinander verglichen hatte. Die Therapieoptionen waren sich hinsichtlich der Ergebnisse ebenbürtig.…”