Medicine
Saman Nasrollazadeh; Behrooz Nazari; Mohammad Irajian
Abstract
Introduction: Volar plate arthroplasty has proven to be an effective surgical intervention for addressing PIP joint pathologies. However, postoperative pain management remains a significant challenge in achieving optimal outcomes. Dorsal blocking pinning has emerged as a potential solution to reduce ...
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Introduction: Volar plate arthroplasty has proven to be an effective surgical intervention for addressing PIP joint pathologies. However, postoperative pain management remains a significant challenge in achieving optimal outcomes. Dorsal blocking pinning has emerged as a potential solution to reduce pain and improve patient satisfaction. By limiting dorsal translation and extension of the PIP joint, this technique may provide additional stability, alleviate discomfort, and promote better healing. Material and Methods: All surgeries were performed by a single experienced orthopedic surgeon specializing in hand surgery. The volar plate arthroplasty technique involved a standard approach with a volar incision, exposure and reduction of the PIP joint, and fixation with a volar plate. In the dorsal blocking pinning group, an additional step was performed following the volar plate fixation. A 1.6 mm Kirschner wire was inserted dorsally into the PIP joint, providing additional stability and limiting dorsal translation and extension of the joint. Results: Pain intensity scores were assessed using the visual analog scale (VAS) at multiple time points postoperatively. In the dorsal blocking pinning group, a significant reduction in pain intensity was observed over time (p<0.001). At 24 hours after surgery, the mean pain score was 6.8 ± 1.2. By 1 week, the pain intensity decreased to 4.2 ± 0.9, and further decreased to 2.1 ± 0.6 at 4 weeks. At the final follow-up of 12 weeks, the mean pain score was 1.5 ± 0.4, indicating a substantial reduction in pain compared to the immediate postoperative period. Conclusion: This study provides evidence supporting the role of dorsal blocking pinning in reducing pain in the PIP joint following volar plate arthroplasty. The additional stability provided by the dorsal blocking pin contributes to improved pain management and potentially enhances patient comfort and satisfaction.
