Crowley Timothy P, Stevenson Susan, Taghizadeh Reika, Addison Patrick, Milner Richard H
Department of Plastic Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
Tech Hand Up Extrem Surg. 2013 Sep;17(3):124-7. doi: 10.1097/BTH.0b013e318284dbd7.
Ulnar collateral ligament (UCL) injuries of the thumb are common. Surgical repair is accepted as the treatment of choice for complete rupture of the ligament. Biomechanical studies have suggested that Mitek bone anchor repairs are potentially safe and strong enough to allow early controlled active mobilization. To date, there have been no studies to compare early active mobilization following Mitek bone anchor repair to standard postoperative rehabilitation involving thumb spica immobilization for the first 4 to 6 weeks. We performed a small pilot randomized control trial to assess the outcome of this new rehabilitation technique to that of standard immobilization following UCL repair with Mitek bone anchor. Our results show that on average early active mobilization leads to an earlier return to full hand function (6 vs. 8 wk) and an earlier return to work (7 vs. 11 wk). There is no difference in the final range of motion achieved. We suggest that Mitek bone anchor repairs for UCL ruptures are robust enough to allow early active mobilization and that a larger trial is warranted to assess whether early active mobilization is superior to standard rehabilitation.
拇指尺侧副韧带（UCL）损伤很常见。手术修复被认为是韧带完全断裂的首选治疗方法。生物力学研究表明，Mitek骨锚修复术可能安全且足够牢固，能够允许早期进行可控的主动活动。迄今为止，尚无研究将Mitek骨锚修复术后的早期主动活动与术后前4至6周采用拇指人字形石膏固定的标准康复方案进行比较。我们开展了一项小型前瞻性随机对照试验，以评估这种新的康复技术与采用Mitek骨锚修复UCL后进行标准固定的效果。我们的结果显示，平均而言，早期主动活动能使手部功能更早恢复正常（6周对8周），并能更早重返工作岗位（7周对11周）。最终达到的活动范围没有差异。我们认为，采用Mitek骨锚修复UCL断裂足够牢固，能够允许早期主动活动，有必要开展更大规模的试验来评估早期主动活动是否优于标准康复方案。
