Primary Repair of the Collateral Ligament of the Proximal Interphalangeal Joint Using a Suture Anchor

Abstract

Ten out of 12 complete ruptures of the collateral ligament of the proximal interphalangeal joint were repaired primarily using a suture anchor. Active finger exercise was started gently by taping the injured finger to adjacent one one week postoperatively. All patients returned to their original occupation or sports activities within seven weeks of operation. No patients complained of pain on the involved finger at rest or during movement. There was no instability of the proximal interphalangeal joint on manual lateral stress test postoperatively.

Clinical outcomes of operative repair of complete rupture of the proximal interphalangeal joint collateral ligament: Comparison with non-operative treatment

“… 7 McCue reported that early surgical repair of injuries yielded good results in young athletes who were cooperative and motivated and who had the benefit of supervised rehabilitation, 6 and Isani and Kato recommended operative repair in young workers and athletes. 4 , 5 , 10 Our results also support operative repair of collateral ligament in patients with grade III collateral ligament injury.…”

“…In cases where there was a remnant of the collateral ligament to suture strongly, we used suture anchors, as these provide strong mechanical stability for early motion exercises, consistent with the findings of mechanical and clinical studies. 4 , 5 , 11 , 12 , 13 We started active motion exercises of the PIP joint 3 days after the operation. Early exercise of the PIP joint is related to rapid functional recovery of PIP joint motion.…”

“…1 ). 3 , 4 , 5 We excluded patients with accompanying injury to the hand and wrist, or with diabetes, rheumatoid arthritis, or degenerative arthritis in the injured hand. Seventeen patients met our criteria, and all injuries were to the radial collateral ligaments.…”

“…1 , 2 , 3 However, some hand surgeons recommend operative repair for complete rupture of the PIP collateral ligament due to residual pain, instability, and weakness of pinch strength after non-operative treatment. 4 , 5 , 6 , 7 However, there is no convincing evidence that operative repair expedites healing or improves motion. 2 The purpose of this study was to evaluate clinical outcomes after operative repair of complete rupture of the PIP collateral ligament compared with those obtained by non-operative treatment.…”

Injuries Around the Proximal Interphalangeal Joint

“…This is still a topic of controversy, however, with some investigators advocating repair only if there is subluxation and closed reduction is not possible, whereas others report that surgical repair is necessary, 21 especially in young workers and athletes. [22][23][24] Collateral ligaments typically fail proximally. If there is enough substance of the collateral ligament on the condyle of the proximal phalanx, it may be repaired directly.…”