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超声引导下经皮腱鞘松解术治疗扳机指后的手指运动功能:术后康复的效果

Finger movement function after ultrasound-guided percutaneous pulley release for trigger finger: effects of postoperative rehabilitation.

作者信息

Lu Szu-Ching, Kuo Li-Chieh, Hsu Hsiu-Yun, Jou I-Ming, Sun Yung-Nien, Su Fong-Chin

机构信息

Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan; Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan.

Department of Occupational Therapy, National Cheng Kung University, Tainan, Taiwan.

出版信息

Arch Phys Med Rehabil. 2015 Jan;96(1):91-7. doi: 10.1016/j.apmr.2014.09.001. Epub 2014 Sep 22.

Abstract

OBJECTIVE

To develop and test a postoperative rehabilitation protocol for use by individuals with trigger finger undergoing ultrasound-guided percutaneous pulley release.

DESIGN

Nonrandomized controlled trial.

SETTING

Hospital and local community.

PARTICIPANTS

Individuals suffering from trigger finger with joint contracture (N=21) were recruited and grouped into an intervention group (n=9) or a control group (n=12).

INTERVENTIONS

All the participants underwent the same surgical procedure performed by the same surgeon. A 4-week postoperative rehabilitation program was designed based on the wound healing process. The intervention group received postoperative rehabilitation after the surgery, whereas the control group received no treatment after the surgery.

MAIN OUTCOME MEASURES

The finger movement functions were quantitatively evaluated before and 1 month after the surgery using a 3-dimensional motion capture system. The fingertip workspace and joint range of motion (ROM) were evaluated while the participant was performing a sequential 5-posture movement, including finger extension, intrinsic plus, straight fist, full fist, and hook fist.

RESULTS

The intervention group demonstrated significantly more improvements than the control group in the fingertip workspace (49% vs 17%), ROM of the distal interphalangeal (DIP) joint (16% vs 4%), ROM of the proximal interphalangeal (PIP) joint (21% vs 5%), and total active ROM (17% vs 5%).

CONCLUSIONS

This pilot study evaluated a postoperative rehabilitation protocol for trigger finger and demonstrated its effects on various finger functions. Participants who underwent the rehabilitation program had significantly more improvements in the fingertip workspace, ROM of the DIP and PIP joints, and total active ROM.

摘要

目的

制定并测试一种用于接受超声引导下经皮滑车松解术的扳机指患者的术后康复方案。

设计

非随机对照试验。

地点

医院及当地社区。

参与者

招募了患有扳机指伴关节挛缩的患者(N = 21),并将其分为干预组(n = 9)和对照组(n = 12)。

干预措施

所有参与者均由同一位外科医生进行相同的手术。根据伤口愈合过程设计了一个为期4周的术后康复计划。干预组在术后接受康复治疗,而对照组术后不接受任何治疗。

主要观察指标

在手术前和术后1个月使用三维运动捕捉系统对手指运动功能进行定量评估。在参与者进行包括手指伸展、固有肌加力、直拳、全拳和钩拳的连续5种姿势运动时,评估指尖工作空间和关节活动范围(ROM)。

结果

干预组在指尖工作空间(49% 对 17%)、远侧指间关节(DIP)的ROM(16% 对 4%)、近侧指间关节(PIP)的ROM(21% 对 5%)以及总主动ROM(17% 对 5%)方面的改善明显多于对照组。

结论

这项初步研究评估了扳机指的术后康复方案,并证明了其对各种手指功能的影响。接受康复计划的参与者在指尖工作空间、DIP和PIP关节的ROM以及总主动ROM方面有明显更多的改善。

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