Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
Arch Phys Med Rehabil. 2012 Oct;93(10):1856-9. doi: 10.1016/j.apmr.2012.03.028. Epub 2012 Apr 5.
Proximal interphalangeal (PIP) joint contractures are notoriously difficult to treat. Best results are obtained with early mobilization and splinting, though a high level of adherence is critical for a good outcome. A new roll-on splint that aims to increase motion with minimal difficulty was used. The patient described here with moderate PIP joint contractures (30°-60°) was treated successfully using this splint. The splint design and therapy protocol are described. The patient was treated for 12 weeks with good adherence to therapy and splinting. Total active motion increased by 87% in the index finger and 108% in the ring finger. Grip, pinch, and tip-pinch strengths increased. The Disabilities of the Arm, Shoulder and Hand score improved from 26.7% to 2.5%. At 3 months, the patient returned to work. Though this case illustrates some of the advantages and disadvantages of the new splint, further study is necessary to evaluate the splint and compare it with other existing forms of treatment for PIP joint contractures.
近节指间(PIP)关节挛缩症的治疗极具挑战性。早期活动和夹板固定可获得最佳效果,但高度的依从性对良好的效果至关重要。一种新的滚动夹板旨在以最小的难度增加运动,这里介绍了一位 PIP 关节挛缩症(30°-60°)中度患者使用这种夹板成功治疗的案例。描述了夹板的设计和治疗方案。患者接受了 12 周的治疗,对治疗和夹板固定的依从性良好。食指的总主动活动度增加了 87%,环指增加了 108%。握力、捏力和指尖捏力增加。手臂、肩部和手部残疾评分从 26.7%改善至 2.5%。3 个月后,患者恢复工作。尽管这个病例说明了新型夹板的一些优点和缺点,但仍需要进一步研究来评估该夹板,并将其与其他现有的 PIP 关节挛缩症治疗方法进行比较。