Outcomes of Acute Operative Repair of Complete Digital Proximal Interphalangeal Joint Collateral Ligament Ruptures: A Systematic Review

Author:

Bui David1,Jenkins Michael2,Schick Bernard1,Sivakumar Brahman Shankar3

Affiliation:

1. Department of Orthopaedic Surgery, Prince of Wales Hospital, Randwick, NSW, Australia

2. Department of Orthopaedic Surgery, Macquarie University Hospital, Macquarie University, NSW, Australia

3. Department of Hand Surgery and Peripheral Nerve Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia

Abstract

Background: No consensus exists regarding the management of complete collateral ligament injuries of the proximal interphalangeal joint (PIPJ) of fingers. Methods: We aimed to systematically review the outcomes of Acute (< 1 month) surgical repairs of these injuries. Outcomes assessed included Stability, Pain, Range-of-Motion and Return to Function. The Modified Coleman Methodology Score (MCMS) was utilised in critical appraisal. Results: 70 patients with complete collateral ligament injuries of the PIPJ were identified in 5 studies. 49 were managed operatively and 21 non-operatively. All trials were methodologically flawed with a mean MCMS of 50.4, corresponding to a “Poor” Level of evidence. Conclusions: Whilst acute surgical repair of complete collateral ligament injuries of finger PIPJs are a described viable management option with promising results, there is insufficient high-quality evidence to inform current practice. Based on the current literature, no evidence-based conclusions can be made regarding superiority of acute surgical repair over conservative management or one method of surgical repair over another. Further high level studies are required.

Publisher

World Scientific Pub Co Pte Ltd

Subject

General Medicine

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