Burge P D, Brown M
Nuffield Orthopaedic Centre, Headington, Oxford.
J Hand Surg Br. 1990 Nov;15(4):443-8. doi: 10.1016/0266-7681(90)90087-k.
Elastic band mobilisation of repaired flexor tendons in zone 2 may be complicated by flexion contracture of the P.I.P. joint. The mechanics of three types of elastic band mobilisation were analysed from lateral video-recordings of finger movement and the flexion moment at the P.I.P. joint was derived at every 10 degrees of flexion. The conventional forearm attachment of the elastic band produced a steep rise in P.I.P. joint flexion moment during extension; this effect was greatest when the M.P. joint was at 70 degrees and least at 20 degrees. Flexion moments for attachments around the dorsum of the hand or under a palmar pulley were lower, uniform throughout the range of P.I.P. joint motion and independent of the position of the M.P. joint. The effort needed to extend the P.I.P. joint is strongly influenced by the method of elastic band attachment; consideration should be given to both tension and moment arm in application of elastic band mobilisation.
2区修复屈肌腱的弹力带活动可能会因近端指间关节屈曲挛缩而变得复杂。通过手指运动的侧面视频记录分析了三种弹力带活动方式的力学原理，并在近端指间关节每屈曲10度时得出其屈曲力矩。弹力带传统的前臂固定方式在伸展过程中会使近端指间关节屈曲力矩急剧上升；当掌指关节处于70度时这种影响最大，处于20度时最小。手部背侧或掌侧滑车周围固定的屈曲力矩较低，在近端指间关节整个运动范围内保持一致，且与掌指关节位置无关。近端指间关节伸展所需的力受弹力带固定方式的强烈影响；在应用弹力带活动时应同时考虑张力和力臂。
