外伤性近指间关节伸直僵硬的治疗

Treatment of post-traumatic proximal interphalangeal joint stiffness

目的探讨外伤后近指间关节伸直僵硬的治疗方法。方法2007年8月至2012年6月，对26例（31指）保守治疗无效的近指间关节伸直僵硬，采取手术松解。术后早期在镇痛药物辅助下行功能锻炼。结果术后26例（31指）获得3～12个月的随访，平均8个月。术后关节屈曲功能均有明显改善，屈度失能角度（F）明显减小，失能值降低，未发现肌腱滑脱及关节不稳者。结论对于各种外伤后非骨性因素导致的近指间关节伸直僵硬，手指背侧松解结合术后镇痛药物和系统康复锻炼是手术成功的必要条件。

Objective To explore treatment options for traumatic proximal interphalangeal （PIP） joint stiffness. Methods From August 2007 to June 2012, surgical intervention was done in 26 cases （31 fingers） of PIP joint stiffness that failed conservative treatment. Early postoperative functional exercises were carried out under pain management with analgesic medication. Results All 26 cases （31 fingers） had follow-up for 3 to 12 months （mean 8 months）. Postoperative joint flexion function was remarkably improved. The joint movement limitation significantly decreased. There was no tendon dislocation and joint instability. Condusion Posttraumatic PIP joint stiffness with the absence of osseous causes can be effectively treated with arthrolysis via a dorsal incision. Postoperative pain management and systematic rehabilitation exercise is a necessary condition for the success of operation.