Chan Rebecca K Y
Occupational Therapy Department, David Trench Rehabilitation Centre, Hong Kong.
Hand Surg. 2002 Dec;7(2):251-9. doi: 10.1142/s0218810402001229.
The prognosis and speed of peripheral nerve recovery depend very much on the level of injury, severity of injury, the surgical intervention and the subsequent rehabilitative process. Many high level injuries may take years or months for the affected peripheral nerve to recover. Prolonged muscle imbalance causes joint contractures and over-stretching of denervated muscles. Without proper care, hand function recovery may be limited even the nerve regenerated afterwards. During the nerve regeneration period, splinting is one of the most useful modality to minimise deformities, prevent joint contractures and substitute loss motor control. Proper splinting encourages early use of the injured hand in daily activities. There are different types of splinting design for median nerve palsy, ulnar nerve palsy and radial nerve palsy. Dynamic splinting techniques are frequently employed to allow early prehension activities. Other therapeutic techniques, including pressure garment and sensory re-education are useful to enhance better functional return after nerve repair.
周围神经恢复的预后和速度在很大程度上取决于损伤的部位、损伤的严重程度、手术干预以及后续的康复过程。许多高位损伤可能需要数月或数年时间,受影响的周围神经才能恢复。长期的肌肉失衡会导致关节挛缩和失神经支配肌肉的过度伸展。如果没有适当的护理,即使神经随后再生,手部功能恢复也可能受到限制。在神经再生期间,夹板固定是减少畸形、预防关节挛缩以及替代丧失的运动控制的最有用方法之一。合适的夹板固定有助于鼓励患者在日常活动中尽早使用受伤的手。针对正中神经麻痹、尺神经麻痹和桡神经麻痹,有不同类型的夹板设计。动态夹板固定技术经常被用于允许早期的抓握活动。其他治疗技术,包括压力衣和感觉再训练,对于促进神经修复后更好的功能恢复很有用。