Sahin Füsun, Yücel Serap Dalgiç, Yilmaz Figen, Ergöz Ernur, Kuran Banu
Department of Physical Therapy and Rehabilitation (Fiziksel Tip ve Rehabilitasyon Kliniği), Sişli Etfal Training and Research Hospital, Istanbul, Turkey.
Acta Orthop Traumatol Turc. 2006;40(4):274-9.
We evaluated demographic and occupational features of patients with phalangeal fractures of the hand, etiologies and types of injuries, and the results of rehabilitation.
The study included 91 fingers of 62 patients (54 males, 8 females; mean age 28+/-13 years; range 4 to 59 years) who were referred to our hand rehabilitation unit for phalangeal fractures. Demographic features, the cause and localization of injury, the type of surgery, time from surgery to rehabilitation, and the follow-up period were determined. At the end of rehabilitation, range of motion (ROM) of the phalangeal joint and total ROM of the injured fingers were assessed using the Strickland-Glogovac rating system.
A great majority of injuries were caused by work accidents, followed by sport injuries and falls occurring in students. Sixty patients (96.8%) were right-handed. The fractures occurred in the dominant hand in 29 patients (46.8%). The majority of patients (n=45) were primary school graduates. The most common mechanism of injury was accidents related to heavy work machinery (n=18). The most commonly injured finger and the phalanx were the third finger (n=25, 27.5%) and the proximal phalanx (n=59, 56.7%), respectively. Only 27 patients (43.6%) had a sufficient follow-up with a mean of 79.7+/-46.6 days (range 30 to 254 days). Following rehabilitation, the mean ROM and the total ROM were 45.0+/-22.9 degrees and 63.3+/-16.1 degrees for the injured joint and the thumb, and 31.3+/-22.5 degrees and 122+/-60.3 degrees for the injured joint and the other fingers, respectively.
Our data provide important insight into appropriate treatment and rehabilitation of phalangeal fractures, in particular, shortcomings in the treatment and follow-up.
我们评估了手部指骨骨折患者的人口统计学和职业特征、损伤的病因和类型以及康复结果。
本研究纳入了62例因指骨骨折转诊至我们手部康复单元的患者的91根手指（54例男性，8例女性；平均年龄28±13岁；范围4至59岁）。确定了人口统计学特征、损伤的原因和部位、手术类型、手术至康复的时间以及随访期。在康复结束时，使用Strickland-Glogovac评分系统评估指骨关节的活动范围（ROM）和受伤手指的总ROM。
绝大多数损伤是由工作事故引起的，其次是运动损伤和学生跌倒。60例患者（96.8%）为右利手。29例患者（46.8%）的骨折发生在优势手。大多数患者（n=45）为小学毕业生。最常见的损伤机制是与重型工作机械相关的事故（n=18）。最常受伤的手指和指骨分别是第三指（n=25，27.5%）和近节指骨（n=59，56.7%）。只有27例患者（43.6%）进行了充分的随访，平均随访79.7±46.6天（范围30至254天）。康复后，受伤关节和拇指的平均ROM和总ROM分别为45.0±22.9度和63.3±16.1度，受伤关节和其他手指的平均ROM和总ROM分别为31.3±22.5度和122±60.3度。
我们的数据为指骨骨折的适当治疗和康复，特别是治疗和随访中的不足提供了重要见解。
