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

Dorien A. Salentijn; Priscilla Jawahier; Marit van Barreveld; Tosca Vrolijk-van Hengel; Niels Schep; Marcel G. W. Dijkgraaf; Mark van Heijl; Ruben N. van Veen

doi:10.1177/15589447261469595

August 18, 2026HandOpen Access

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

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Key Points

To determine whether a self-management exercise regimen is noninferior to supervised hand therapy in patients recovering from stable proximal interphalangeal joint hyperextension or dorsal dislocation injuries.
Multicenter, open randomized noninferiority trial enrolling adult patients with a stable, congruent proximal interphalangeal joint after dorsal dislocation or hyperextension injury with volar plate avulsion.
Assessed outcomes at 3 months using the Michigan Hand Outcomes Questionnaire change score from baseline, applying a predefined noninferiority margin of −8 points.
In the modified intention-to-treat analysis (N = 100 per arm), the mean difference in 3-month Michigan Hand Outcomes Questionnaire score change was −0.6 (95% CI, −4.4 to 3.2; P = .0001 for noninferiority).
In the per-protocol analysis (self-management: N = 85; supervised therapy: N = 79), the mean difference in score change was 0.4 (95% CI, −3.5 to 4.4; P = .000026 for noninferiority), with no safety issues reported.

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Implication

Randomized noninferiority trial demonstrates self-management exercises match supervised hand therapy for proximal interphalangeal joint injuries, suggesting home routines safely reduce therapist...

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Salentijn et al. (2026) studied this question.

synapsesocial.com/papers/6a86b5318a91293e6a1cc959 https://doi.org/10.1177/15589447261469595

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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

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Cite This Study

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

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