title: [Surgical treatment of stiff metacarpophalangeal joint after hand injury].
abstract: OBJECTIVE
  To discuss the surgical procedures and curative effect of stiff 2-5 metacarpophalangeal (MP) joints after crash injury in hand.
  
  
  METHODS
  Between January 2006 and June 2009, 7 cases of stiff 2-5 MP joints were treated by releasing the stiff MP joints and reconstructing the function of lumbrical muscle in one stage. There were 6 males and 1 female with an average age of 32 years (range, 18-56 years). All injuries were caused by crash. Six cases suffered from multiple metacarpal fracture or complex dislocation of MP joint and 1 case suffered from complete amputation at level of middle palm of hand. The interval from initial wound healing to hospitalization was 3 to 15 months. Before operation, the X-ray films showed fracture healed and the results of nipping paper test were positive. All hands were treated with physical therapy for 1 month. After the plaster external fixation for 6 weeks, the physical therapy and function training were given.
  
  
  RESULTS
  All wounds healed by first intention. The patients had no joint instability and extensor tendon side-slipping with normal finger function. Six patients were followed up from 6 months to 3 years. The extension and flexion of MP joint were 0 degree and 67-90 degrees, respectively. The average grip strength of injured dominant hand reached 86.70% of normal side and non-dominant hand reached 66.70% of normal side. The average injured dominant tip pinch strength reached 83.52% of normal side and non-dominant tip pinch strength reached 61.30% of normal side. Based on total active motion (TAM) system of Chinese Medical Association for Hand Surgery, the results were excellent in 4 cases, good in 1 case, and fair in 1 case; the excellent and good rate was 83.33%.
  
  
  CONCLUSIONS
  In patients with stiff MP joint and lumbrical muscle defect, releasing stiff MP joint and reconstructing lumbrical function in one stage can recover the function of MP joint and achieve good outcome. Physical therapy plays an important role before operation.
authors.affiliation: Wuxi Hand Surgery Hospital, Wuxi Jiangsu, 214061, PR China. ruiyj@hotmail.com
authors.forename: Yongjun
authors.initials: Y
authors.lastname: Rui
authors.forename: Haifeng
authors.initials: H
authors.lastname: Shi
authors.forename: Jingyi
authors.initials: J
authors.lastname: Mi
authors.forename: Guang
authors.initials: G
authors.lastname: Chen
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.forename: Jun
authors.initials: J
authors.lastname: Qian
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D008662:Metacarpophalangeal Joint / Q000293:injuries* / Q000601:surgery; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D055815:Young Adult