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二区屈肌腱修复采用动态牵引夹板固定的进一步经验。

Further experience in rehabilitation of zone II flexor tendon repair with dynamic traction splinting.

作者信息

Saldana M J, Chow J A, Gerbino P, Westerbeck P, Schacherer T G

机构信息

Department of Orthopedics, Portsmouth Naval Hospital, Va.

出版信息

Plast Reconstr Surg. 1991 Mar;87(3):543-6. doi: 10.1097/00006534-199103000-00023.

Abstract

A review of all flexor tendon repairs in the "no man's land" performed from January of 1985 to June of 1987 was done to evaluate the efficacy of our method of rehabilitation. There were 60 fingers (57 patients) with complete laceration of the flexor digitorum profundus and flexor digitorum superficialis tendons in zone II. Fingers with phalangeal fractures, joint injuries, or significant skin loss were excluded. Follow-up ranged from 12 to 48 months. Rehabilitation consisted of a 12-week protocol using the U.S. military combined regimen of controlled motion. Features from the technique of controlled active extension against rubber band passive flexion as well as those of controlled passive extension and passive flexion were incorporated. The palmar pulley modification of Kleinert's dynamic traction splint was utilized. Strickland's total active motion formula was employed to determine results. The results were classified into the four categories of excellent, good, fair, and poor. Fifty-two fingers (86 percent) were rated excellent, 4 fingers (7 percent) were rated good, 1 finger (2 percent) was rated fair, and 3 fingers (5 percent) were rated poor.

摘要

对1985年1月至1987年6月期间在“无人区”进行的所有屈指肌腱修复手术进行回顾,以评估我们的康复方法的疗效。在II区有60根手指(57例患者)的指深屈肌腱和指浅屈肌腱完全断裂。排除伴有指骨骨折、关节损伤或大面积皮肤缺损的手指。随访时间为12至48个月。康复采用为期12周的方案,使用美国军方的控制运动联合疗法。该方案纳入了对抗橡皮筋被动屈曲的控制主动伸展技术以及控制被动伸展和被动屈曲技术的特点。采用了Kleinert动态牵引夹板的掌侧滑车改良法。采用Strickland的总主动活动度公式来确定结果。结果分为优、良、可、差四类。52根手指(86%)评定为优,4根手指(7%)评定为良,1根手指(2%)评定为可,3根手指(5%)评定为差。

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