Saldana M J, Choban S, Westerbeck P, Schacherer T G
Department of Orthopedics, Naval Hospital, Portsmouth, VA 23708.
J Hand Surg Am. 1991 Nov;16(6):1145-50. doi: 10.1016/s0363-5023(10)80082-6.
Motivated by the favorable results of dynamic splinting in the treatment of more proximal extensor tendon injuries, we explored the use of dynamic splinting in the treatment of zone III extensor tendon lacerations. Twenty-two tendon repairs in 19 patients were available for review. On the basis of degree of extension lag and pulp-to-palm distance, 14 repairs were rated as excellent, 6 as good, and 2 as fair. Using total active motion at 10 weeks, the proximal interphalangeal and distal interphalangeal joints averaged 170 degrees. There was one mild boutonniere deformity. The results of this prospective study show that carefully monitored dynamic splinting is safe in the treatment of zone III lacerations. When results were compared with the results of our method of static splinting used prior to this prospective study, patients returned to full activities with good-to-excellent results 8 weeks earlier instead of at 16 to 18 weeks.
鉴于动态夹板在治疗更近端伸肌腱损伤方面取得了良好效果，我们探讨了动态夹板在治疗Ⅲ区伸肌腱撕裂伤中的应用。对19例患者的22处肌腱修复情况进行了回顾性分析。根据伸直滞后程度和指腹至手掌距离，14处修复评定为优秀，6处为良好，2处为尚可。在术后10周时，近端指间关节和远端指间关节的总主动活动度平均为170度。出现1例轻度纽扣畸形。这项前瞻性研究的结果表明，在治疗Ⅲ区撕裂伤时，仔细监测下的动态夹板固定是安全的。将结果与本前瞻性研究之前使用的静态夹板固定方法的结果进行比较时，患者恢复完全活动的时间提前了8周，而非16至18周，且效果良好至优秀。
