Application of modified progressive static splinting for treatment of traumatic metacarpophalangeal joint stiffness

中华手外科杂志 Pub Date : 2019-02-10 DOI:10.3760/CMA.J.ISSN.1005-054X.2019.01.008

Lin Xiaoke, Ling Jingjing, Xiao Ni, Gao-bao Zhuo, Y. Jin, Shenghu Du, Fangzheng Yu

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Abstract

Objective To investigate the application and efficacy of modified progressive static splinting (National Invention Patent No. 201610777015.8) in the treatment of traumatic metacarpophalangeal joint stiffness. Methods From October 2016 to December 2017, 32 cases (97 fingers) of traumatic metacarpophalangeal joint stiffness were treated in our hospital. Among them, 16 cases (48 fingers) were given routine rehabilitation and progressive static splinting (group A) and 16 cases (49 fingers) were given routine rehabilitation and modified progressive static splinting (group B). The active and passive range of motion (AROM, PROM), visual analogue scale (VAS), Minnesota Manual Dexterity Test (MMDT), Disability of the Arm, Shoulder and Hand (DASH) questionnaire, Semmes-Weinstein Monofilaments Examination (SWME) of the two groups were compared before and 2, 4, 6 weeks after the treatment. Results Before the rehabilitation treatment, there was no significant difference in AROM, PROM, VAS, MMDT time, DASH and SWME value between the two groups (P>0.05). After the treatment, AROM and PROM increased significantly, MMDT time shortened significantly, DASH and VAS scores decreased significantly, and SWME value increased significantly (P< 0.05). After the treatment, AROM and PROM of group B were significantly greater than those of group A, MMDT time of group B was significantly shorter than that of group A, DASH and VAS scores of group B were significantly lower than those of group A, and SWME value of group B was significantly smaller than that of group A (P < 0.05). Conclusion The modified progressive static splinting is better than traditional progressive static splinting in the treatment of traumatic metacarpophalangeal joint stiffness. The treatment process is more comfortable. It is easier to improve the dexterity of the hand and the ability of daily activities. It is worthy of clinical application. Key words: Metacarpophalangeal joint; Rehabilitation; Splinting; 3D printing

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改良渐进式静态夹板治疗外伤性掌指关节强直

目的探讨改良渐进式静态夹板(国家发明专利号:201610777015.8)在外伤性掌指关节僵硬中的应用及疗效。方法2016年10月至2017年12月收治外伤性掌指关节僵硬32例(97指)。其中16例(48根手指)给予常规康复+渐进式静态夹板(A组)，16例(49根手指)给予常规康复+改良渐进式静态夹板(B组)。主动、被动活动度(AROM、PROM)、视觉模拟量表(VAS)、明尼苏达手工灵巧度测试(MMDT)、臂肩手残疾(DASH)问卷、比较两组治疗前及治疗后2、4、6周的Semmes-Weinstein单丝检查(SWME)。结果康复治疗前，两组患者的AROM、PROM、VAS、MMDT时间、DASH、SWME值比较，差异均无统计学意义(P < 0.05)。治疗后，患者AROM、PROM显著升高，MMDT时间显著缩短，DASH、VAS评分显著降低，SWME值显著升高(P< 0.05)。治疗后，B组患者的AROM、PROM均显著高于A组，MMDT时间显著短于A组，DASH、VAS评分均显著低于A组，SWME值显著小于A组(P < 0.05)。结论改良渐进式静态夹板治疗外伤性掌指关节僵硬的效果优于传统渐进式静态夹板。治疗过程更舒适。更容易提高手的灵巧度和日常活动能力。值得临床推广应用。关键词:掌指关节;康复;用夹板固定;3 d打印技术

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中华手外科杂志

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