Saito Kazuo, Kihara Hitoshi
Department of Rehabilitation Center, Fuchinobe General Hospital, Sagamihara, Kanagawa, Japan.
Kihara Orthopaedic Clinic, Saitama, Japan.
J Hand Ther. 2016 Oct-Dec;29(4):433-439. doi: 10.1016/j.jht.2016.07.005. Epub 2016 Oct 18.
A randomized clinical trial, with patients treated either by new 2-step orthosis or by the figure-eight-type orthosis with the distal interphalangeal (DIP) joint extended.
To report on our new orthosis and to evaluate the treatment efficacy of using a 2-step orthosis for the treatment of a mallet finger of tendinous origin compared with a conventional orthosis.
Forty-four patients were randomized into the 2-step or conventional orthosis groups. Primary outcomes were active DIP joint flexion and extensor lag, pain, and the Abouna-Brown criteria.
The 2-step orthosis was associated with a smaller active DIP extensor lag, compared with the conventional orthosis (-7.5 ± 4.5° vs -16.4 ± 6.9°, P = .001), combined with a significantly higher Abouna-Brown criteria (χ = 14.57, P = .01). No other between-group differences were identified.
The therapeutic effectiveness of the 2-step orthosis, over a conventional orthosis, was supported by a large effect size of the treatment in improving residual active extensor lag at the DIP and overall Abouna-Brown criteria. Our study thus suggested that the initial immobilization involved in new 2-step orthosis and is thus a good immobilization technique.
Ib.
一项随机临床试验，患者分别接受新型两步矫形器治疗或远侧指间关节（DIP）伸展位的8字绷带矫形器治疗。
报告我们的新型矫形器，并评估与传统矫形器相比，使用两步矫形器治疗腱性锤状指的治疗效果。
44例患者被随机分为两步矫形器组或传统矫形器组。主要观察指标为DIP关节主动屈曲和伸肌滞后、疼痛以及阿布纳-布朗标准。
与传统矫形器相比，两步矫形器的DIP关节主动伸肌滞后更小（-7.5±4.5°对-16.4±6.9°，P = 0.001），同时阿布纳-布朗标准显著更高（χ=14.57，P = 0.01）。未发现其他组间差异。
两步矫形器在改善DIP关节残余主动伸肌滞后和总体阿布纳-布朗标准方面具有较大的治疗效应量，这支持了其优于传统矫形器的治疗效果。因此，我们的研究表明，新型两步矫形器所涉及的初始固定是一种良好的固定技术。
Ib级。
