2区屈肌腱修复后控制活动的两种方法的比较。

P T Ali Kitis, Nihal Buker, Inci Gokalan Kara
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引用次数: 51

摘要

采用两种不同的早期控制活动方案,对192例患者263根手指的2区屈肌腱损伤进行初步修复后的结果进行了评估。126名男性和66名女性(年龄从18岁到57岁)被分为两组。采用改良Kleinert方案(Washington方案)早期主动活动夹板法治疗98例患者137根手指,术后采用可控被动活动方案治疗94例患者126根手指。在评估过程中,对患者进行了总主动运动(TAM)、握力和手臂、肩部和手部残疾(DASH)问卷调查。术后12周对所有患者进行复查,并采用Buck-Gramcko-II评分系统对结果进行评估。华盛顿方案组总主动运动为“优”(n= 119,87%),对照被动运动组手指活动为“优”(n= 94,75%)。在华盛顿方案组中,受伤手的平均握力为非受伤侧的89%,而在被动运动控制组中,这一比例为81%。两组患者的平均DASH评分分别为30分和42分。我们认为动态夹板控制的主动活动改善了上肢的结果,包括活动范围、握力和手部在屈肌腱修复中的功能状态。
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Comparison of two methods of controlled mobilisation of repaired flexor tendons in zone 2.

The results after primary repair of zone 2 flexor tendon injuries were evaluated in 263 fingers in 192 patients using two different early-controlled mobilisation programmes. There were 126 men and 66 women (age range 18 to 57 years) divided into two groups. Ninety-eight patients with 137 fingers were treated by early active mobilisation with dynamic splinting method according to a modified Kleinert regimen (Washington regimen), and 94 patients with 126 fingers were managed with a controlled passive movement regimen postoperatively. During this evaluation patients were evaluated for total active movement (TAM), grip strength, and disabilities of arm, shoulder, and hand (DASH) questionnaire. All patients were also reviewed 12 weeks after operation and the results assessed by the Buck-Gramcko-II system. Total active movement was "excellent" in the Washington regimen group (n=119, 87%), while excellent results of the fingers were achieved in the controlled passive movement group (n=94, 75%). The mean grip strength of the injured hand was 89% that of the non-injured side in the Washington regimen group, compared with 81% in the controlled passive movement group. The mean DASH score was 30 and 42 in the two groups, respectively. We think that controlled active mobilisation with dynamic splinting improves the outcome in the upper extremity, including range of movement, grip strength, and functional state of the hand in repairs of the flexor tendons.

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