Laoopugsin Niyom, Thepchatri Arunwongse, Sukavanich Pawaris
Department of Orthopedics, Faculty of Medicine, Srinakharinwirot University. Nakhon Nayok, Thailand.
J Med Assoc Thai. 2013 Jan;96 Suppl 1:S5-11.
To evaluate the invented device for early continuous passive motion with the rehabilitation program of fingers following flexor tendon repair in zone-II and to determine whether early motion of the affected finger can occur without increasing the rates of subsequent tendon rupture.
A quazi experimental study was done between January 2011 and August 2011 by selecting 5 cases with both, flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) injuried in zone II of a finger using standard exclusion criteria. The operation was performed by a single surgeon using a standard four-strand repair suture technique and postoperative care consisted of a rehabilitation program with early continuous, passive motion using and original device. The program was started 1 week post operatively with duration of 4 months. The authors evaluated the total active motion (TAM) by means of the Strickland-Glogovac formula and calculated results by using the Strickland's original classification system. The ratio of efficiency (E1/E2) was analyzed.
In evaluation of the TAM, there were 2 cases with excellent results and good results in 3 cases. The range of motion obtained was nearly full motion in all 5 of the cases without subsequent tendon rupture. The ratio of efficiency (E1/E2) was 85/ 100 (85 of Baktir/100 of the present study) and higher than standard (80/80). As the total number of cases and the selection of cases were different (76 cases of Baktir/5 cases of the present study).
Early continuous passive motion using this originally invented device provides excellent long-term outcomes in the management of injured flexor tendon in zone II. Further studies should be done to compare our results with other continuous passive motion protocols with the inclusion of long term follow-up and measurements of grip strength.
评估用于Ⅱ区屈指肌腱修复术后手指康复计划的早期连续被动活动的发明装置,并确定患指早期活动是否会在不增加后续肌腱断裂发生率的情况下发生。
2011年1月至2011年8月进行了一项准实验研究,采用标准排除标准选择5例手指Ⅱ区浅屈肌腱(FDS)和深屈肌腱(FDP)均损伤的患者。手术由一名外科医生采用标准的四股修复缝合技术进行,术后护理包括使用原始装置进行早期连续被动活动的康复计划。该计划在术后1周开始,持续4个月。作者通过Strickland-Glogovac公式评估总主动活动度(TAM),并使用Strickland原始分类系统计算结果。分析效率比(E1/E2)。
在TAM评估中,2例结果优秀,3例结果良好。所有5例患者获得的活动范围几乎为全活动范围,且无后续肌腱断裂。效率比(E1/E2)为85/100(Baktir的85/本研究的100),高于标准值(80/80)。由于病例总数和病例选择不同(Baktir的76例/本研究的5例)。
使用这种原创发明的装置进行早期连续被动活动,在Ⅱ区屈指肌腱损伤的治疗中提供了出色的长期效果。应进行进一步研究,将我们的结果与其他连续被动活动方案进行比较,并纳入长期随访和握力测量。