{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T19:10:42Z","timestamp":1777662642583,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2019,2,14]],"date-time":"2019-02-14T00:00:00Z","timestamp":1550102400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:p>Background: Tendon adhesions and capsular contractures following trauma to the proximal interphalangeal joint (PIPJ) may significantly reduce hand function. Traditional, staged surgical management prioritizes restoration of PIPJ passive range of motion with joint release prior to restoration of active range of motion (AROM) with tenolysis. This is expensive and burdensome for patients. Our objective was to evaluate functional outcomes of combined PIPJ release and zone II flexor tenolysis. Methods: We retrospectively reviewed patients who underwent combined PIPJ release and flexor tenolysis. Replantation and tendon graft cases were excluded. Data were collected on pre- and postoperative AROM, total active motion (TAM), tip to distal palmar crease (DPC) distance, and grip strength. Functional outcomes were graded using the Boyes, American Society for Surgery of the Hand, and modified Strickland scores. Results: Twelve patients (9 men and 3 women, median age = 40 years) with a total of 15 digits underwent combined PIPJ release and flexor tenolysis a median of 10.1 months after injury. At a median follow-up of 4.0 months, there were significant improvements in median PIPJ AROM (15\u00b0 to 70\u00b0), TAM (105\u00b0 to 223\u00b0), tip to DPC distance (6.0 to 2.0 cm), and grip strength (35% to 54% of unaffected hand). Modified Strickland score was good in 46% of digits and excellent in 38%. There were no tendon ruptures, surgical site infections, or devascularized digits. Conclusion: Proximal interphalangeal joint stiffness is a challenging complication of hand trauma. Although a complete return to premorbid range of motion and function is rarely attained with surgery, improved outcomes may be consistently achieved with secondary combined PIPJ release and zone II flexor tenolysis.<\/jats:p>","DOI":"10.1177\/1558944719828005","type":"journal-article","created":{"date-parts":[[2019,2,14]],"date-time":"2019-02-14T12:58:26Z","timestamp":1550149106000},"page":"502-508","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Outcomes of Secondary Combined Proximal Interphalangeal Joint Release and Zone II Flexor Tenolysis"],"prefix":"10.1177","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8499-701X","authenticated-orcid":false,"given":"Kevin J.","family":"Zuo","sequence":"first","affiliation":[{"name":"University of Toronto, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moaath","family":"Saggaf","sequence":"additional","affiliation":[{"name":"University of Toronto, Toronto, ON, Canada"},{"name":"King Abdulaziz University, Jeddah, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herbert P.","family":"von Schroeder","sequence":"additional","affiliation":[{"name":"University of Toronto, Toronto, ON, Canada"},{"name":"Toronto Western Hospital, University Health Network, University of Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Binhammer","sequence":"additional","affiliation":[{"name":"University of Toronto, Toronto, ON, Canada"},{"name":"Sunnybrook Health Sciences Centre, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,2,14]]},"reference":[{"key":"bibr1-1558944719828005","doi-asserted-by":"publisher","DOI":"10.1080\/00015458.2006.11679952"},{"key":"bibr2-1558944719828005","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000434411.78335.63"},{"key":"bibr3-1558944719828005","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000000090"},{"key":"bibr4-1558944719828005","doi-asserted-by":"publisher","DOI":"10.1016\/j.main.2015.04.002"},{"key":"bibr5-1558944719828005","doi-asserted-by":"publisher","DOI":"10.1097\/01.sap.0000174357.03839.2a"},{"key":"bibr6-1558944719828005","doi-asserted-by":"publisher","DOI":"10.1016\/j.hcl.2004.12.003"},{"key":"bibr7-1558944719828005","doi-asserted-by":"publisher","DOI":"10.1016\/j.hcl.2004.11.008"},{"key":"bibr8-1558944719828005","doi-asserted-by":"publisher","DOI":"10.1016\/j.cps.2011.08.006"},{"key":"bibr9-1558944719828005","volume-title":"Flexor Tendon Injury","author":"Seiler JG","year":"2011","edition":"6"},{"key":"bibr10-1558944719828005","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199606000-00011"},{"key":"bibr11-1558944719828005","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"bibr12-1558944719828005","doi-asserted-by":"publisher","DOI":"10.1177\/1753193408090762"},{"key":"bibr13-1558944719828005","doi-asserted-by":"publisher","DOI":"10.1093\/bmb\/ldp013"},{"key":"bibr14-1558944719828005","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-196749040-00009"},{"key":"bibr15-1558944719828005","volume-title":"Tenolysis: Pain Control and Rehabilitation","author":"Hunter JW","year":"1982","edition":"3"},{"key":"bibr16-1558944719828005","doi-asserted-by":"publisher","DOI":"10.1016\/0363-5023(89)90056-7"},{"key":"bibr17-1558944719828005","doi-asserted-by":"publisher","DOI":"10.1016\/S0363-5023(77)80028-2"},{"key":"bibr18-1558944719828005","doi-asserted-by":"publisher","DOI":"10.1016\/0266-7681(93)90192-I"},{"key":"bibr19-1558944719828005","doi-asserted-by":"publisher","DOI":"10.1142\/S0218810496000221"},{"key":"bibr20-1558944719828005","first-page":"198","volume":"28","author":"Hahn P","year":"1996","journal-title":"Handchir Mikrochir Plast Chir"}],"container-title":["HAND"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1558944719828005","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1558944719828005","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1558944719828005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:29:50Z","timestamp":1777447790000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1558944719828005"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,14]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,7]]}},"alternative-id":["10.1177\/1558944719828005"],"URL":"https:\/\/doi.org\/10.1177\/1558944719828005","relation":{},"ISSN":["1558-9447","1558-9455"],"issn-type":[{"value":"1558-9447","type":"print"},{"value":"1558-9455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,14]]}}}