Subscribe to RSS
DOI: 10.1055/s-0044-1793921
Treatment of Sagittal Plane Instability of the Proximal Interphalangeal Joint: Ultrasound-Guided Volar Plate Scarification Technique
Article in several languages: español | English
Abstract
Introduction Laxity in the volar plate of the proximal interphalangeal joint can result in sagittal plane instability due to its incompetence, accompanied by digital hyperextension with dorsal subluxation, loss of functionality, and pain.
Objectives Present a series of cases of patients with sagittal instability of the volar plate of the proximal interphalangeal plate treated with a minimally invasive surgical technique and evaluate the short and medium-term results.
Material and Methods Patients treated with a minimally invasive surgical technique involving ultrasound-guided scarification of the volar plate for the treatment of laxity in the proximal interphalangeal joint that leads to hyperextension deformity. This technique has been used in five patients in a prospective study with a one-year follow-up, where the percutaneous technique is followed by a splinting and joint rehabilitation protocol.
Results Positive outcomes demonstrating improved joint stability, reduced pain, and enhanced function with a rate of resolution of the proximal interphalangeal joint hyperextension and blockage in a 100%, and improvement in the Quick-DASH and Mayo Wrist Score.
Conclusions The results have demonstrated that it is a safe method with good outcomes for patients with sagittal plane instability associated with volar plate laxity.
Publication History
Received: 12 February 2024
Accepted: 07 October 2024
Article published online:
23 December 2024
© 2024. SECMA Foundation. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
Bibliografía
- 1 Kaplan EB. Extension deformities of the proximal inter- phalangeal joints of the fingers. J Bone Joint Surg Am 1939; 18: 781-783
- 2 Bunnell S. Surgery of the Hand, ed. 2. Philadelphia: 1948. JB Lippincott Co;
- 3 Moller JT. Lesions of the volar fibrocartilago in finger joints. A 2-year material. Acta Orthop Scand 1974; 45 (05) 673-682
- 4 Bowers WH. The proximal interphalangeal joint volar plate. II: a clinical study of hyperextension injury. J Hand Surg Am 1981; 6 (01) 77-81
- 5 McKeon KE, Lee DH. Posttraumatic Boutonnière and Swan Neck Deformities. J Am Acad Orthop Surg 2015; 23 (10) 623-632
- 6 Carlo J, Dell PC, Matthias R, Wright TW. Collateral Ligament Reconstruction of the Proximal Interphalangeal Joint. J Hand Surg Am 2016; 41 (01) 129-132
- 7 Lane R, Nallamothu SV. Swan-Neck Deformity. In: StatPearls. Treasure Island (FL): StatPearls Publishing; June 26, 2023
- 8 Smith GC, Amirfeyz R. The flexible swan neck deformity in rheumatoid arthritis. J Hand Surg Am 2013; 38 (07) 1405-1407
- 9 García Bernal FJ, Nevado Sánchez E. Tratamiento de la inestabilidad en plano sagital de la articulación interfalángica proximal mediante reparación de la placa volar. Revista Iberoamericana de Cirugía de la Mano 2022; 50 (01) e64-e68
- 10 Lee SK. Modern tendon repair techniques. Hand Clin 2012; 28 (04) 565-570
- 11 Thompson JS, Littler JW, Upton J. The spiral oblique retinacular ligament (SORL). J Hand Surg Am 1978; 3 (05) 482-487
- 12 van der Giesen FJ, Nelissen RG, van Lankveld WJ. et al. Swan neck deformities in rheumatoid arthritis: a qualitative study on the patients' perspectives on hand function problems and finger splints. Musculoskeletal Care 2010; 8 (04) 179-188
- 13 Catalano III LW, Skarparis AC, Glickel SZ. et al. Treatment of chronic, traumatic hyperextension deformities of the proximal interphalangeal joint with flexor digitorum superficialis tenodesis. J Hand Surg Am 2003; 28 (03) 448-452
- 14 Ko JH, Kalainov DM, Hsu LP, Fang RC, Mastey RD. Double lateral band transfer for treatment of traumatic hyperextension instability of the proximal interphalangeal joint: a report of two cases. Hand (N Y) 2012; 7 (01) 108-113
- 15 Zaidenberg E, Saba JS, Rellan I, Cesca FJ, Pastrana M, Zaidenberg CR. Volar Capsulodesis With Early Active Motion for the Treatment of Chronic Proximal Interphalangeal Joint Hyperextension Deformity. J Hand Surg Am 2023; 48 (12) 1275.e1-1275.e6
- 16 Ahmed HA, Goldie BS. Proximal interphalangeal joint instability: a dynamic technique for stabilization. J Hand Surg [Br] 2002; 27 (04) 354-355
- 17 Matsuo T, Suzuki T, Kimura H, Iwamoto T. Modified Thompson-Littler Method for Chronic Instability of the Proximal Interphalangeal Joint: A Report of Two Cases. J Hand Surg Asian Pac Vol 2023; 28 (01) 125-128
- 18 Paczesny Ł, Zabrzyński J, Domżalski M. et al. Mini-Invasive, Ultrasound Guided Repair of the Achilles Tendon Rupture-A Pilot Study. J Clin Med 2021; 10 (11) 2370