Wong Josephine M W
Department of Occupational Therapy, Prince of Wales Hospital, Shatin, New Territories, Hong Kong China.
Hand Surg. 2002 Dec;7(2):261-9. doi: 10.1142/s0218810402001217.
Joint stiffness, resulting from a variety of complications after hand injuries, remains a common problem. Prolonged swelling, scar formation and shortening of soft tissue after prolonged period of immobilisation are the major causes leading to the loss of joint range of motion. Treatment used to improve the joint stiffness should be integrative and problem-focused. Pressure therapy, active and passive mobilisation through remedial activities and corrective splinting should be started as soon as problems arise. Applying low-load stress through prolonged periods of time onto the shortened tissue at its maximum tolerable range is the main principle in restoration of passive joint range of motion. The greater the joint limitation becomes, the longer the time the splint should be applied. Therapists should understand the process of tissue healing and different functions of splints before a correct and effective splint can be prescribed properly.
手部受伤后因各种并发症导致的关节僵硬仍然是一个常见问题。长时间肿胀、瘢痕形成以及长期固定后软组织缩短是导致关节活动范围丧失的主要原因。用于改善关节僵硬的治疗应是综合性且以问题为导向的。一旦出现问题，就应开始压力疗法、通过康复活动进行主动和被动活动以及使用矫正夹板。在缩短组织的最大耐受范围内长时间施加低负荷应力是恢复被动关节活动范围的主要原则。关节受限越严重，夹板应用的时间就应越长。在正确有效地开具夹板处方之前，治疗师应了解组织愈合过程以及夹板的不同功能。
