ArticleHand (New York, N.Y.)2026
Self-Management Exercise Regimen Versus Supervised Hand Therapy in Patients With Dorsal Dislocation or Hyperextension Injury With a Volar Plate Avulsion of the Proximal Interphalangeal Joint: The Randomized Controlled PINOT Study.
Article in Hand (New York, N.Y.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
8 authors.
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Abstract
backgroundSupervised hand therapy (SHT) with early mobilization is recommended for patients with a stable, congruent proximal interphalangeal (PIP) joint after dorsal dislocation or hyperextension injury with a volar plate avulsion. Early mobilization uses a dorsal block splint. A self-management exercise regimen (SMER) may offer a valuable alternative that reduces demand on therapists. We hypothesized that SMER is noninferior to SHT.
methodsNoninferiority was assessed in adult patients in a multicenter, open randomized trial. Noninferiority to SHT had to be shown in both the modified intention-to-treat (mITT) and per-protocol (PP) analysis sets. The predefined noninferiority margin was -8 points, about half the minimal clinically important difference, with a 1-sided critical
resultsThe mITT analysis set contained 100 patients in each treatment group. The mean difference at 3 months in Michigan Hand Outcomes Questionnaire (MHQ) change score from baseline was -0.6 (95% CI, -4.4 to 3.2;
conclusionsThe randomized controlled trial showed that SMER for patients with a stable and congruent joint alignment after dorsal dislocation or hyperextension injury with a volar plate avulsion fracture of the PIP joint is clinically noninferior regarding hand function compared with SHT. LEVEL OF EVIDENCE: I.
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