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在改良Kleinert疗法中增加主动屈曲对1至3区屈肌腱修复结果的影响。一项前瞻性随机试验。

The effect of adding active flexion to modified Kleinert regime on outcomes for zone 1 to 3 flexor tendon repairs. A prospective randomized trial.

作者信息

Rigó István Zoltán, Haugstvedt Jan-Ragnar, Røkkum Magne

机构信息

1 Department of Orthopaedic Surgery, Østfold Hospital, Moss, Norway.

2 Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.

出版信息

J Hand Surg Eur Vol. 2017 Nov;42(9):920-929. doi: 10.1177/1753193417728406. Epub 2017 Aug 23.

Abstract

UNLABELLED

In a prospective randomized study, we studied whether adding active flexion to a modified Kleinert regime changed outcomes of flexor tendon repairs in zone 1, 2 and 3 in 73 fingers (53 patients). Evaluation included active range of finger motion, grip and pinch strengths. Twelve months after surgery, the increase in range of active finger motion after adding active flexion was insignificant compared with that with the modified Kleinert regime. According to the Strickland criteria, 20 out of 29 fingers had excellent or good recovery after adding active flexion, as did 28 out of 34 fingers with the modified Kleinert regime; we could not detect significant improvement of the good and excellent rate. At 6 months, the pinch strength was significantly higher with the addition of active flexion. We failed to find that adding active finger flexion to the modified Kleinert regime improves the overall long-term results of repairs in zone 1 to 3, though recovery appeared faster, and the good and excellent recovery of zone 2 repairs was 17% greater with the active flexion protocol.

LEVEL OF EVIDENCE

I.

摘要

未标记

在一项前瞻性随机研究中,我们研究了在改良Kleinert疗法基础上增加主动屈曲是否会改变73根手指(53例患者)1区、2区和3区屈指肌腱修复的结果。评估包括手指活动范围、握力和捏力。术后12个月,增加主动屈曲后手指主动活动范围的增加与改良Kleinert疗法相比无显著差异。根据Strickland标准,增加主动屈曲后29根手指中有20根恢复良好或优秀,改良Kleinert疗法的34根手指中有28根恢复良好或优秀;我们未发现优良率有显著提高。在6个月时,增加主动屈曲后捏力显著更高。我们发现,在改良Kleinert疗法基础上增加手指主动屈曲并不能改善1区至3区修复的总体长期效果,尽管恢复似乎更快,且主动屈曲方案使2区修复的优良恢复率提高了17%。

证据水平

I级。

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