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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

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Effective Period of Conservative Treatments in Patients with Acute Calcific Periarthritis of the Hand

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  • presenting/speaker Kee Jeong Bae - Seoul National University Boramae Medical Center, Seoul, South Korea
  • Ji Hyeung Kim - Seoul National University Hospital, Seoul, South Korea
  • Do Weon Lee - Seoul National University Hospital, Seoul, South Korea
  • Yo Han Lee - Seoul National University Hospital, Seoul, South Korea
  • Yeun soo Kim - Seoul National University Hospital, Seoul, South Korea
  • Young Ju Chae - Seoul National University Hospital, Seoul, South Korea
  • Che Ho Lee - Seoul National University Hospital, Seoul, South Korea
  • Qingyuan Li - Seoul National University Hospital, Seoul, South Korea
  • Hyun Sik Gong - Seoul National University Bundang Hospital, Seongnam, South Korea
  • Goo Hyun Baek - Seoul National University Hospital, 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. DocIFSSH19-596

doi: 10.3205/19ifssh0878, urn:nbn:de:0183-19ifssh08782

Published: February 6, 2020

© 2020 Bae et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: Acute calcific periarthritis of the hand is a relatively uncommon painful condition with juxta-articular deposits of amorphous calcium hydroxyapatite. Although conservative treatments has been generally regarded effective, there is not much evidence about how long they could be effective.

Methods: We retrospectively reviewed 11 patients who were diagnosed as acute calcific periarthritis of the hand from January 2015 to June 2018. We recommended the use of warm baths, nonsteroidal anti-inflammatory drugs (NSAIDs) and limitation of the activity as an initial treatment. If the pain persisted in spite of the at least 3-months conservative treatments, we explained surgical treatment options. If the pain improved, we recommended gradual range of motion exercises with continuation of daily NSAIDs. Each visual analog scale (VAS) for pain at every 3 months visit (3 months, 6 months, 9 months) were compared with that of previous visit to investigate whether the pain had decreased or not during each time interval. Simple radiographs taken at every 3 months visit were compared with those of previous visit to determine any significant change in calcification amounts during each time interval.

Results and Conclusions: Except one patient with immediate surgical reconstruction of collateral ligaments, 10 patients having 17 affected joints continued the conservative treatments for average 11.1 months. Average pain VAS score at initial visit was 7, while that of 3 months, 6 months and 9 months were 4.3, 3.3 and 2.9 respectively. There was significant reduction in pain VAS scores at 3 months and at 6 months, but not at 9 months (P-value = 0.004, 0.008 and 0.598 respectively). Simple radiographs also showed significant reduction of calcification amounts at 3 months and at 6 months, but not at 9 months (P-value = 0.020, 0.034 and 0.083 respectively).

Patients with acute calcific periarthritis of the hand revealed residual pain and calcifications for relatively prolonged period. Those who continued the conservative treatments including NSAIDs medication showed relieved pain and reduced calcification up to 6 months. This results suggested that the conservative treatments could be tried for at least 6 months before deciding surgical treatments for calcific periarthritis of the hand.