From the Research
The diagnosis and treatment of a palmar interosseous injury should prioritize a modified outside-in suture through the joint capsule to repair the Palmer I-B triangular fibrocartilage complex superficial injury, as it has shown good clinical effect and is worthy of clinical widespread promotion 1.
Diagnosis
The diagnosis of a palmar interosseous injury can be challenging, but high-resolution 3-T MRI can provide detailed injury patterns, including capsular injuries, horizontal tear of the articular disk, and bucket-handle tear 2.
Treatment
Treatment typically involves:
- Rest, ice, compression, and elevation (RICE protocol) for 48-72 hours after injury
- Over-the-counter pain medications like ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours) to manage pain and inflammation
- Gentle stretching and strengthening exercises after the acute pain subsides, usually within 5-7 days, including finger abduction/adduction movements and grip strengthening with putty or a soft ball, performed 3 times daily with 10-15 repetitions
- A hand splint may be beneficial during sleep for 1-2 weeks
- If pain persists beyond 2-3 weeks or if there is significant weakness or deformity, medical evaluation is necessary as surgery might be required for complete tears
Rehabilitation
Recovery typically takes 4-6 weeks for minor injuries but can extend to 8-12 weeks for more severe cases. Proper rehabilitation is essential to restore hand function and prevent chronic weakness or stiffness. Some key points to consider:
- Ultrasound-guided steroid injections at the site of adhesions could be considered a promising treatment option prior to surgical management 3
- Early, controlled mobilization is superior to immobilization for primary treatment of acute musculoskeletal soft-tissue injuries and postoperative management 4