Our Summary

This research paper looks into the best way to treat a specific type of finger injury, where ligaments near the middle joint of the finger are completely damaged. They looked at studies where these injuries were treated with surgery within a month of happening, and assessed the outcomes based on how stable the finger was afterwards, how much pain the patient had, how much they could move the finger, and how well they could use the finger again.

They found 70 patients with this injury in five studies, and out of these, 49 had surgery and 21 were treated without surgery. They found that all of these studies were not very well-conducted, meaning the evidence they provide isn’t very strong.

In summary, while some promising results were found for treating these injuries with surgery, the quality of the evidence isn’t good enough to definitively say that surgery is the best treatment. The researchers couldn’t decide if surgery is better than non-surgical treatment, or if one type of surgery is better than another. They conclude that more, better-quality studies are needed.

FAQs

  1. What is the consensus on managing complete collateral ligament injuries of the proximal interphalangeal joint of fingers?
  2. What are the outcomes of acute surgical repairs of complete collateral ligament injuries of the PIPJ of fingers?
  3. Is there sufficient high-quality evidence to determine the superiority of acute surgical repair over conservative management for these types of injuries?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hand surgery is to follow post-operative instructions carefully, including keeping the hand elevated, performing recommended exercises, and attending follow-up appointments to ensure proper healing and optimal outcomes.

Suitable For

Patients who may be recommended for hand surgery typically include those with:

  1. Complete collateral ligament injuries of the proximal interphalangeal joint (PIPJ) of fingers
  2. Chronic hand conditions such as arthritis or carpal tunnel syndrome
  3. Traumatic injuries such as fractures or tendon injuries
  4. Congenital hand abnormalities
  5. Tumors or cysts in the hand or wrist
  6. Severe hand pain or dysfunction that does not respond to conservative treatments

It is important for patients to consult with a hand surgeon to determine the most appropriate treatment plan for their specific condition.

Timeline

Before hand surgery:

  • Patient experiences an injury to the collateral ligament of the proximal interphalangeal joint (PIPJ) of the finger
  • Patient may undergo diagnostic imaging to assess the extent of the injury
  • Patient may receive conservative treatment such as splinting or physical therapy

After hand surgery:

  • Patient undergoes acute surgical repair of the complete collateral ligament injury
  • Patient may experience post-operative pain and swelling
  • Patient begins rehabilitation and physical therapy to regain range of motion and strength in the hand
  • Patient is monitored for stability and function of the PIPJ
  • Patient eventually returns to normal function and activities, with varying outcomes depending on the success of the surgery and rehabilitation process.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with hand surgery for a complete collateral ligament injury of the proximal interphalangeal joint?
  2. What is the expected recovery time and rehabilitation process following surgery for this type of injury?
  3. Are there alternative treatment options to consider besides surgery for a complete collateral ligament injury of the PIPJ?
  4. How successful is surgery typically in restoring stability, reducing pain, improving range of motion, and returning function to the hand after this type of injury?
  5. What is the surgeon’s experience and success rate with performing acute surgical repair for complete collateral ligament injuries of the PIPJ?
  6. Are there any specific post-operative care instructions or precautions that I should be aware of following surgery for this type of injury?
  7. How long will I need to wear a splint or cast after surgery, and when can I expect to resume normal activities and use of my hand?
  8. Will I need physical therapy or other forms of rehabilitation to aid in recovery and regain strength and function in my hand?
  9. What is the likelihood of experiencing long-term complications or issues with the hand after undergoing surgery for this type of injury?
  10. Are there any lifestyle or activity modifications that I should consider making to prevent re-injury or further damage to the hand following surgery for a complete collateral ligament injury of the PIPJ?

Reference

Authors: Bui D, Jenkins M, Schick B, Sivakumar BS. Journal: J Hand Surg Asian Pac Vol. 2021 Dec;26(4):644-653. doi: 10.1142/S2424835521500624. PMID: 34789094