Abstract
BackgroundMucous cyst of the distal interphalangeal joint (DMC) or interphalangeal connection of the thumb is common in middle-aged and elderly people, and it often occurs in the fingers of people with osteoarthritis (OA). Although there are many conservative treatments, DMC is usually treated by surgery. The common complications of surgical treatment are recurrence of DMC and skin necrosis. This article introduces the method and clinical effect of osteophyte excision and joint debridement in the treatment of DMC of the distal interphalangeal (DIP) joint.MethodsIn total, 19 cases of affected fingers made an 'S' incision in the DIP joint under local anesthesia to remove the osteophyte of the DIP joint, clean the dorsal joint capsule, wash the joint, and retain only the bilateral collateral ligament and extensor tendon device. It is suspected that the injured finger of the extensor tendon should be protected by external fixation.ResultsOut of 15 patients, 1 patient presented with partial skin necrosis that healed after dressing changes while the other patients recovered well. The visual analog scale (VAS) scores of all affected fingers after surgery were lower than those before the surgery (VAS score: 4.93 ± 0.88 vs. 4.07 ± 1.03, p < 0.05). The range of motion (ROM) of the affected finger decreased in one patient, and the post-operative activity of the other fingers increased in varying degrees (ROM: 67.60 ± 5.40 vs. 71.27 ± 7.06, p > 0.05).ConclusionsUsing osteophyte excision and joint debridement to treat DMC can avoid skin necrosis caused by cyst removal and can avoid the recurrence of DMC to the greatest extent, so it is a safe and effective way of treatment.
Highlights
The mucous cyst of the distal interphalangeal joint (DMC), known as a joint tendon sheath cyst, is one of the common hand tumors seen in clinic [1]
Of the 19 incisions on the fingers of these 15 patients, 18 incisions met the criteria for primary healing and 1 had skin necrosis around the incision
There was no rupture of the extensor tendon and cyst recurrence, range of motion (ROM) of the affected finger was increased (ROM: 67.60 ± 5.40 vs. 71.27 ± 7.06, p > 0.05), and the pain of finger activity was improved (VAS score: 4.93 ± 0.88 vs. 4.07 ± 1.03, p < 0.05)
Summary
The mucous cyst of the distal interphalangeal joint (DMC), known as a joint tendon sheath cyst, is one of the common hand tumors seen in clinic [1]. The cyst of the DIP joint of the finger can rupture and cause the gelatinous material to enter the surrounding tissue from the lesion or flow out of the capsule wall. In this case, the cyst will heal and fill within a few weeks, resulting in a recurrence of DMC, so it is difficult to achieve full recovery [3,4,5,6,7,8]. Mucous cyst of the distal interphalangeal joint (DMC) or interphalangeal connection of the thumb is common in middle-aged and elderly people, and it often occurs in the fingers of people with osteoarthritis (OA). This article introduces the method and clinical effect of osteophyte excision and joint debridement in the treatment of DMC of the distal interphalangeal (DIP) joint
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