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There is currently no real consensus on the optimal management of acute sprains of the proximal interphalangeal joint of the long fingers.
The aim of this study is to assess the beneficial effect of an injection of corticosteroids for the treatment of this type of sprain (one single sub-cutaneous injection, in the acute phase). This treatment, if effective, might become the treatment of choice for these types of injuries, instead of a prolonged immobilization or a careful early mobilization.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Diprophos | Experimental | Patients having had a sprain of the long fingers, within 2 weeks of consultation. This group will receive a single injection of corticoids. |
|
| Control group | No Intervention | Patients having had a sprain of the long fingers (Eaton classification type I and II), within 2 weeks of consultation. This group will receive the standard of care treatment, without injection of corticoids. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Diprophos | Drug | Single subcutaneous injection of Diprophos, in the acute phase. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Flexion/extension deficit | Evaluation of the maximal amplitude of the articulation, as measured by a goniometer. | Baseline (day of kenacort injection) |
| Flexion/extension deficit | Evaluation of the maximal amplitude of the articulation, as measured by a goniometer. | 7 days after injection |
| Flexion/extension deficit | Evaluation of the maximal amplitude of the articulation, as measured by a goniometer. | 30 days after injection |
| Laxity in hyperextension | Evaluation of the maximal amplitude of the articulation, as measured by a goniometer. | Baseline (day of kenacort injection) |
| Laxity in hyperextension | Evaluation of the maximal amplitude of the articulation, as measured by a goniometer. | 7 days after injection |
| Laxity in hyperextension | Evaluation of the maximal amplitude of the articulation, as measured by a goniometer | 30 days after injection |
| Diameter of the articulation | Oedema evaluation. Collateral comparison with the same finger of the other hand: result expressed as a ratio | Baseline (day of kenacort injection) |
| Diameter of the articulation |
| Measure | Description | Time Frame |
|---|---|---|
| EVA scale | Pain assessment at the level of the volar plate | 7 days after injection |
| EVA scale | Pain assessment at the level of the volar plate |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Nader Chahidi, MD | Clinique du Parc Léopold | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU Brugmann | Brussels | 1020 | Belgium | |||
| Clinique du Parc Leopold |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 10088864 | Background | Freiberg A, Pollard BA, Macdonald MR, Duncan MJ. Management of proximal interphalangeal joint injuries. J Trauma. 1999 Mar;46(3):523-8. doi: 10.1097/00005373-199903000-00033. No abstract available. | |
| 23450596 | Background | Chalmer J, Blakeway M, Adams Z, Milan SJ. Conservative interventions for treating hyperextension injuries of the proximal interphalangeal joints of the fingers. Cochrane Database Syst Rev. 2013 Feb 28;2013(2):CD009030. doi: 10.1002/14651858.CD009030.pub2. |
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| ID | Term |
|---|---|
| D013180 | Sprains and Strains |
| ID | Term |
|---|---|
| D014947 | Wounds and Injuries |
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| ID | Term |
|---|---|
| C032812 | betamethasone dipropionate, betamethasone sodium phosphate drug combination |
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Oedema evaluation. Collateral comparison with the same finger of the other hand: result expressed as a ratio |
| 7 days after injection |
| Diameter of the articulation | Oedema evaluation. Collateral comparison with the same finger of the other hand: result expressed as a ratio | 30 days after injection |
| Prehension force | Assessed by a dynamometer (Jamar hydraulic gauge). Result expressed as a ratio with the prehension force of the non-injured hand. | Baseline (day of kenacort injection) |
| Prehension force | Assessed by a dynamometer (Jamar hydraulic gauge). Result expressed as a ratio with the prehension force of the non-injured hand. | 7 days after injection |
| Prehension force | Assessed by a dynamometer (Jamar hydraulic gauge). Result expressed as a ratio with the prehension force of the non-injured hand. | 30 days after injection |
| 30 days after injection |
| Mini-DASH | Assessment of the return to daily life activities or sport activities. Questionnaire of the Disabilities of the Arm, Shoulder and Hand. | 7 days after injection |
| Mini-DASH | Assessment of the return to daily life activities or sport activities. Questionnaire of the Disabilities of the Arm, Shoulder and Hand. | 30 days after injection |
| Mitchigan Hand Questionnaire | Auto-evaluation of the patient regarding the functionality of his/her articulation | 7 days after injection |
| Mitchigan Hand Questionnaire | Auto-evaluation of the patient regarding the functionality of his/her articulation | 30 days after injection |
| Brussels |
| 1040 |
| Belgium |
| 24503231 | Background | Paschos NK, Abuhemoud K, Gantsos A, Mitsionis GI, Georgoulis AD. Management of proximal interphalangeal joint hyperextension injuries: a randomized controlled trial. J Hand Surg Am. 2014 Mar;39(3):449-54. doi: 10.1016/j.jhsa.2013.11.038. Epub 2014 Feb 4. |
| 26143967 | Background | Micev AJ, Saucedo JM, Kalainov DM, Wang L, Ma M, Yaffe MA. Surgical Techniques for Correction of Traumatic Hyperextension Instability of the Proximal Interphalangeal Joint: A Biomechanical Study. J Hand Surg Am. 2015 Aug;40(8):1631-7. doi: 10.1016/j.jhsa.2015.05.011. Epub 2015 Jul 3. |