Complications associated with volar plate injuries to the PIPJ (Eaton type I, II, IIIA) are commonly reported in the literature and include FFD of the PIPJ, PIPJ extension lag, persistent pain, persistent oedema, reduced flexion and reduced grip strength.
These common complications are usually managed through hand therapy intervention. The hand therapists at Sydney Hospital Hand Unit are experienced therapists able to identify and treat these complications. In addition, all treating and assessing hand therapists will be provided with training that will include identification and treatment of these impairments. A treatment guideline has been developed to assist with managing these impairments.
Less common complications associated with volar plate injuries to the PIPJ include instability and re-dislocation of the PIPJ. These complications are not anticipated to occur as joints that are unstable are more likely to be associated with Eaton Type IIIb and are excluded from this study.
If an unanticipated event occurs these will be reported back to the researcher by face- to-face communication; email or phone. The researcher is on site, which should make reporting of incidents from a research point of view easy and efficient. The assessing therapists will also be able to identify complications at each assessment point using the assessment sheet; if a re-dislocation occurs an incident report should be lodged by the treating/assessing therapist. If an incident report is made the researcher will be notified via email. This is as per standard clinical practice within the hand unit at Sydney Hospital.
In terms of clinical management of less common complications these will be managed as per standard practice. There are clear management guidelines established within the hand unit at Sydney Hospital and include; reviewing the patient with a senior hand therapist in the team; organising a medical review for the patient by liaising with a person in the medical team in the hand clinic, by contacting the on-call hand surgeon and organising an urgent review and by lodging an incident report via the online reporting system.
A document will be used to record common and uncommon complications in both groups and reviewed by the investigative team every 3 months. Any strong imbalance between treatment groups will be reported to the clinical head of the Hand Unit and the Ethics Committee who may terminate the trial.
These common complications are usually managed through hand therapy intervention. The hand therapists at Sydney Hospital Hand Unit are experienced therapists able to identify and treat these complications. In addition, all treating and assessing hand therapists will be provided with training that will include identification and treatment of these impairments. A treatment guideline has been developed to assist with managing these impairments.
Less common complications associated with volar plate injuries to the PIPJ include instability and re-dislocation of the PIPJ. These complications are not anticipated to occur as joints that are unstable are more likely to be associated with Eaton Type IIIb and are excluded from this study.
If an unanticipated event occurs these will be reported back to the researcher by face- to-face communication; email or phone. The researcher is on site, which should make reporting of incidents from a research point of view easy and efficient. The assessing therapists will also be able to identify complications at each assessment point using the assessment sheet; if a re-dislocation occurs an incident report should be lodged by the treating/assessing therapist. If an incident report is made the researcher will be notified via email. This is as per standard clinical practice within the hand unit at Sydney Hospital.
In terms of clinical management of less common complications these will be managed as per standard practice. There are clear management guidelines established within the hand unit at Sydney Hospital and include; reviewing the patient with a senior hand therapist in the team; organising a medical review for the patient by liaising with a person in the medical team in the hand clinic, by contacting the on-call hand surgeon and organising an urgent review and by lodging an incident report via the online reporting system.
A document will be used to record common and uncommon complications in both groups and reviewed by the investigative team every 3 months. Any strong imbalance between treatment groups will be reported to the clinical head of the Hand Unit and the Ethics Committee who may terminate the trial.
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