Vishwanathan Karthik, Ganjiwale Deepak
Department of Orthopaedic, PSMC, Shree Krishna Hospital, Anand, Gujarat, India.
Department of Physiotherapy, KMPIP, Shree Krishna Hospital, Anand, Gujarat, India.
J Family Med Prim Care. 2018 Jan-Feb;7(1):242-245. doi: 10.4103/jfmpc.jfmpc_14_17.
Splinting is a great domain of occupational therapy profession. Making a splint for the patient would depend on the need or requirement of the problems and deformities. Swan neck deformity is an uncommon condition, and it can be seen in rheumatoid arthritis, cerebral palsy, and after trauma. Conservative treatment of the swan neck deformity is available by different static splints only. There are very few reports of surgical correction of swan-neck deformity in benign hypermobility syndrome. This case report describes the result of novel surgical intervention and an innovative hand splint in a 20-year-old female with a history of cardiovascular stroke with no residual neurological deficit. She presented with correctable swan neck deformity and failed to improve with static ring splints to correct the deformity. She underwent volar plate plication of the proximal interphalangeal joint of the left ring finger along with hemitenodesis of ulnar slip of flexor digitorum superficialis (FDS) tendon whereby, the ulnar slip of FDS was passed through a small surgically created rent in A2 pulley and sutured back to itself. Postoperatively, the patient was referred to occupational therapy for splinting with the instruction that the splint would work sometimes for as static and some time as dynamic for positional and correction of the finger. After occupational therapy intervention and splinting, the patient had a full correction of the swan-neck deformity with near full flexion of the operated finger and can work independently.
夹板固定是职业治疗领域的一个重要方面。为患者制作夹板将取决于问题和畸形的需求。鹅颈畸形是一种不常见的病症，可在类风湿性关节炎、脑瘫以及创伤后出现。鹅颈畸形的保守治疗仅可通过不同的静态夹板进行。关于良性关节过度活动综合征中鹅颈畸形手术矫正的报道非常少。本病例报告描述了对一名20岁女性进行新型手术干预和创新手部夹板治疗的结果，该女性有心血管中风病史且无残留神经功能缺损。她表现为可矫正的鹅颈畸形，使用静态环形夹板矫正畸形未取得改善。她接受了左手环指近端指间关节掌板折叠术以及指浅屈肌腱尺侧束半腱固定术，即指浅屈肌腱尺侧束穿过A2滑车手术造成的小裂口并缝合回自身。术后，患者被转介至职业治疗科进行夹板固定，医嘱要求夹板有时作为静态夹板，有时作为动态夹板用于手指的定位和矫正。经过职业治疗干预和夹板固定后，患者的鹅颈畸形得到完全矫正，手术手指近乎完全屈曲，并且能够独立工作。
