RESUMEN
The ultimate effectiveness of an arthroplasty is most accurately determined by a long-term review of the joints' function and freedom from pain. We examined 17 patients an average of 11.5 years (range, 4-26 years) following volar plate arthroplasty for a fracture-dislocation of the proximal interphalangeal joint. All surgeries were performed by the same surgeon. The average age was 36 years (range, 17-61 years). No patient complained of pain at rest or with activity. Patients having arthroplasty within 4 weeks of injury attained a total active range of motion of 85 degrees (50 degrees to 110 degrees ). Patients having arthroplasty more than 4 weeks after injury (average, 20 weeks) included several elderly women and averaged 61 degrees (30 degrees to 90 degrees ) total active range of motion. Four patients showed some degree of joint narrowing at the follow-up examination. This review suggests that volar plate arthroplasty continues to be of benefit on a long-term basis and provides satisfactory function and pain-free motion.
Asunto(s)
Artroplastia/instrumentación , Traumatismos de los Dedos/cirugía , Articulaciones de los Dedos/cirugía , Fracturas Conminutas/cirugía , Luxaciones Articulares/cirugía , Rango del Movimiento Articular/fisiología , Adolescente , Adulto , Artroplastia/métodos , Placas Óseas , Niño , Preescolar , Estudios de Evaluación como Asunto , Femenino , Traumatismos de los Dedos/diagnóstico por imagen , Estudios de Seguimiento , Fracturas Conminutas/diagnóstico por imagen , Humanos , Luxaciones Articulares/diagnóstico , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Satisfacción del Paciente , Radiografía , Sensibilidad y Especificidad , Resultado del TratamientoRESUMEN
The understanding of early controlled range of motion adapted to the stability of the fracture is crucial in postfracture shoulder therapy. The diagnosis and management of proximal humeral fractures have been reviewed. In addition, the aspects of therapy and the pertinent rehabilitation protocols are outlined. Although this article outlines standard treatment approaches, the specific therapy should be individualized to the patient's goals and abilities, and continuous communication between all persons involved in the patient's care is essential for achieving the best possible outcome.