gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

Prognostic factors for conservatively treated sagittal band injuries of the metacarpophalangeal joint

Meeting Abstract

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  • presenting/speaker Young Hak Roh - Ewha Womans University College of Medicine, Ewha Womans University Medical Center, Seoul, South Korea
  • Seok Woo Hong - Ewha Womans University College of Medicine, Ewha Womans University Medical Center, Seoul, South Korea

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-455

doi: 10.3205/19ifssh1071, urn:nbn:de:0183-19ifssh10714

Veröffentlicht: 6. Februar 2020

© 2020 Roh et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objectives/Interrogation: Most sagittal band injuries can be nonsurgically managed with relative motion extension splintage, especially in the acute setting, although optimal management of subacute and chronic sagittal band injuries remains controversial [1]. The aim of this study was to evaluate the factors that influence the prognoses for patients with sagittal band injuries who were treated conservatively.

Methods: A total of 94 patients who had been diagnosed with traumatic sagittal band injury and initially treated with 7 weeks of relative motion extension splintage (5 weeks of full time followed by 2 weeks of part time use, Table 1 [Tab. 1]) were enrolled. The response to treatment, including finger range of motion (ROM), extensor tendon instability, grip strength, and functional outcome measured as Quick Disability of the Arm, Shoulder, and Hand score were assessed at 24-week follow-up. The factors that were assessed for their influence on the outcomes were age, sex, occupation, hand dominance, type of injury, injury severity, time to treatment, and the duration of splintage.

Results and Conclusions: After 24 weeks’ follow-up, 67 (71%) patients achieved resolution of symptomatic tendon translocation with 78% of grip strength and 90% of ROM compared to the un-affected hand, and final mean QuickDASH scores was 15. However, 27 (29%) patients had persistently symptomatic tendon subluxation and of those, 18 (19%) underwent surgical repair. There were significantly more manual laborers in the failure group than in the success group. Subjects in the treatment failure group were older, had longer symptom durations, and were more likely to have grade III injuries than were those in the success group. Multivariable analysis revealed that manual labor (Odds ratio [OR], 3.4), longer symptom duration (OR, 3.9), and grade III injury (OR, 2.4) were associated with a higher likelihood of conservative treatment failure for sagittal band injuries.


References

1.
Peelman J, Markiewitz A, Kiefhaber T, Stern P. Splintage in the treatment of sagittal band incompetence and extensor tendon subluxation. J Hand Surg Eur Vol. 2015 Mar;40(3):287-90.