Millrose Michael, Kim Simon, Eichenauer Frank, Gesslein Markus, Eisenschenk Andreas, Asmus Ariane
BG Unfallklinik Murnau Abteilung für Unfallchirurgie und Sporttraumatologie.
Ernst-Moritz-Arndt Universitat Greifswald Klinik und Poliklinik für Unfall-, Wiederherstellungschirurgie und Rehabilitative Medizin.
Handchir Mikrochir Plast Chir. 2021 Feb;53(1):61-66. doi: 10.1055/a-1344-8928. Epub 2021 Feb 15.
The objective of this study was to evaluate the outcome of a special interdisciplinary hand therapy program depending on the time interval between trauma and rehabilitation.
With use of self-assessed scores (Disability of the Arm, Shoulder and Hand Score [DASH-Score], European Quality of Life 5 Dimensions [EQ-5D]) and objective functional parameters (TAM = Total Active Motion for finger injuries, ROM = Range of Motion for wrist injuries, grip strength) the outcome of 76 patients with injuries of the fingers, wrist or a complex regional pain syndrome (CRPS) was analysed at the begin and end of an inpatient rehabilitation and at a follow-up examination after 12 to 16 weeks. The patients were divided into groups with an early (< 120 days after trauma) or late beginning of their rehabilitation.
At the follow-up examination early beginners had a significant better DASH-Score as well as a ROM. At the end of the rehabilitation program and at the time of the follow-up examination significant more patients with an early as patients with a late start of the rehabilitation were back to work. Especially patients with CRPS and finger injuries benefit from an early start of the rehabilitation.
Compared to a late start an early start of a rehabilitation program after finger and hand injuries and a CRPS leads to better functional with special benefit for patients with a CRPS.
本研究的目的是根据创伤与康复之间的时间间隔,评估一个特殊的跨学科手部治疗项目的效果。
使用自我评估评分(手臂、肩部和手部残疾评分 [DASH 评分]、欧洲生活质量五维度 [EQ-5D])和客观功能参数(手指损伤的总主动活动度 [TAM]、腕部损伤的活动范围 [ROM]、握力),在住院康复开始和结束时以及 12 至 16 周后的随访检查中,分析了 76 例手指、腕部损伤或复杂性区域疼痛综合征(CRPS)患者的治疗效果。患者被分为康复开始早(创伤后 < 120 天)或晚的组。
在随访检查中,早期开始康复的患者 DASH 评分和 ROM 明显更好。在康复项目结束时和随访检查时,康复开始早的患者比开始晚的患者重返工作岗位的人数明显更多。尤其是 CRPS 和手指损伤患者从早期开始康复中受益。
与康复开始晚相比,手指和手部损伤以及 CRPS 后早期开始康复项目能带来更好的功能恢复,对 CRPS 患者有特别的益处。