Efficacy of ultrasound-guided capsular hydrodilatation for refractory post-trauma finger joint stiffness in adult patients.

BACKGROUND

Finger joint stiffness is a common post-treatment complication in patients with upper limb fractures that lowers their quality of life. Physiotherapy is the standard of care for functional restoration in patients with finger joint stiffness. However, in adult patients, physiotherapy alone is not always sufficient to restore joint function. In this study, we report the efficacy of ultrasound-guided capsular hydrodilatation in adult patients with post-trauma finger joint stiffness that did not improve after ≥ 2 weeks of conventional physiotherapy.

METHODS

This prospective study included adult patients who developed finger joint stiffness after conservative treatment with plaster of Paris or open reduction and internal fixation for upper limb injuries between March 2023 and June 2024. All patients underwent ultrasound-guided hydrostatic separation of the finger joint capsules followed by conventional finger joint exercises. The outcomes of treatment were evaluated two weeks post-treatment.

RESULTS

A total of 15 patients with an average age of 58.13 ± 17.64 years were included in this study. The mean pain score decreased from 6.4 ± 1.06 cm to 1.93 ± 0.70 cm respectively (p < 0.0001) at baseline and 2 weeks post-treatment. The median joint swelling score decreased from 2 at baseline to 0 at 2 weeks post-treatment (p < 0.0001). The active ranges of motion increased by 51 ± 4.48 degrees, 18.27 ± 4.62 degrees, and 29.73 ± 4.79 degrees for the MCP, PIP, and DIP joints, respectively. Similarly, the passive ranges of motion increased by 43.4 ± 4.72, 13.27 ± 5.73 degrees, and 26.73 ± 4.83 degrees for the MCP, PIP, and DIP joints, respectively.

CONCLUSION

Ultrasound-guided capsular hydrodilatation in combination with conventional finger joint exercises is an effective intervention for post-trauma finger joint stiffness that is refractory to conventional physiotherapy in adult patients. It is a relatively simple and minimally invasive procedure that can rapidly reduce pain, and swelling, and restore finger joint function.