RESUMO
We report on an acute, open PIP joint injury to the ring finger with associated loss of the ulnar condyle of the proximal phalanx, which was repaired by the removal of bone fragments and replacement of the bone defect with a proximally based palmar plate flap.
Assuntos
Amputação Traumática/cirurgia , Traumatismos dos Dedos/cirurgia , Articulações dos Dedos/cirurgia , Fraturas Intra-Articulares/cirurgia , Instabilidade Articular/diagnóstico por imagem , Instabilidade Articular/cirurgia , Ligamentos Articulares/lesões , Retalhos Cirúrgicos/cirurgia , Ulna/lesões , Adulto , Amputação Traumática/diagnóstico por imagem , Fios Ortopédicos , Fixação Interna de Fraturas/métodos , Humanos , Ligamentos Articulares/cirurgia , Masculino , Modelos Anatômicos , Modalidades de Fisioterapia , Cuidados Pós-Operatórios/métodos , Radiografia , ContençõesRESUMO
We present the results of treatment of a neglected fracture of the base of the middle phalanx of the ring finger, with dorsal proximal interphalangeal joint dislocation. A modified palmar plate arthroplasty technique was used with the removal of bony remnants and non-anatomic palmar plate insertion to the fracture site. At one-year follow-up the patient showed excellent recovery with an active range of motion of the ring finger of 290° (93% of the other side), strong total grip (48 kg) and a quick DASH score of 11. X-ray images showed perfect re-building of the palmar lip of the base of the middle phalanx with no signs of arthritis. Other options for the treatment of acute and chronic PIP joint fracture dislocations are discussed.
Assuntos
Artroplastia/métodos , Traumatismos em Atletas/cirurgia , Traumatismos dos Dedos/cirurgia , Articulações dos Dedos/cirurgia , Fixação Interna de Fraturas/métodos , Fraturas Cominutivas/cirurgia , Fraturas Intra-Articulares/cirurgia , Luxações Articulares/cirurgia , Placa Palmar/cirurgia , Adulto , Traumatismos em Atletas/diagnóstico , Diagnóstico Tardio , Traumatismos dos Dedos/diagnóstico , Fraturas Cominutivas/diagnóstico , Humanos , Fraturas Intra-Articulares/diagnóstico , Luxações Articulares/diagnóstico , MasculinoRESUMO
The objective of this study was to compare the 3 commonly used questionnaires DASH, PEM and Levine to assess which is the best as an outcome measure after carpal tunnel release. 50 patients (43 women and 7 men) with an average age of 56 years underwent minimally invasive carpal tunnel release. Patients were examined before the operation, and at 1 and 6 months after, according to the same protocol. They completed the DASH, PEM and Levine questionnaires and undertook total grip, key-pinch strengths, and sensation by filament tests. The results showed higher responsiveness to change in the Levine and the PEM, compared to the DASH at the 1- and 6-month-assessments. The Levine showed the highest validity as it correlated strongly with all functional measures, although all 3 questionnaires, including Levine, showed a discordance with total grip and key-pinch strength at the 1-month assessment. The instruments were characterized by various (excellent and poor) concurrent validity in the assumed periods of observation and all 3 showed high internal consistency.
