Gelberman R H, Nunley J A, Osterman A L, Breen T F, Dimick M P, Woo S L
Massachusetts General Hospital, Department of Orthopaedic Surgery, Boston 02114.
Clin Orthop Relat Res. 1991 Mar(264):189-96.
A prospective multicenter clinical study was carried out to determine whether improved tendon gliding could be achieved with greater durations of daily passive-motion rehabilitation after flexor tendon repair. Fifty-one patients were placed randomly into two controlled passive-motion protocols. Group 1 patients received greater intervals of passive-motion rehabilitation using a continuous passive-motion device. Group 2 patients were treated with a traditional early passive-motion protocol for tendon rehabilitation. For Group 1 patients, the mean interval of controlled motion rehabilitation was 75 hours a week, and the mean number of cycles was 12,000. For Group 2 patients the mean interval of controlled passive motion was four hours a week, and the mean number of cycles was 1000. The minimum follow-up time was six months (mean, 10.8 months). Using Strickland and Glogovac's formula, the mean active motion for digits in Group 1 was 138 degrees +/- 6 degrees. Mean motion for tendons in Group 2 was 119 degrees +/- 8 degrees. The difference between Groups 1 and 2 was statistically significant. The effect of the number of tendons injured per digit within each group was not significant. The data from this experiment indicate that the duration of the daily controlled motion interval is a significant variable insofar as postrepair flexor tendon function is concerned.
开展了一项前瞻性多中心临床研究，以确定屈肌腱修复术后每日进行更长时间的被动活动康复是否能改善肌腱滑动。51例患者被随机分为两种被动活动方案。第1组患者使用持续被动活动装置接受更长时间间隔的被动活动康复。第2组患者采用传统的早期肌腱康复被动活动方案治疗。对于第1组患者，控制运动康复的平均时间间隔为每周75小时，平均循环次数为12,000次。对于第2组患者，控制被动活动的平均时间间隔为每周4小时，平均循环次数为1000次。最短随访时间为6个月（平均10.8个月）。使用斯特里克兰德（Strickland）和格洛戈瓦茨（Glogovac）的公式，第1组手指的平均主动活动度为138度±6度。第2组肌腱的平均活动度为119度±8度。第1组和第2组之间的差异具有统计学意义。每组中每个手指受伤肌腱数量的影响不显著。该实验数据表明，就修复后屈肌腱功能而言，每日控制运动间隔的时长是一个重要变量。
