Chilliwack General Hospital, 45600 Menholm Rd, Chilliwack BC, V2P 1P7, Canada.
Hand Surg Rehabil. 2021 Oct;40(5):631-636. doi: 10.1016/j.hansur.2021.04.005. Epub 2021 Apr 24.
The phalangeal and metacarpal fractures are common fractures of the upper extremity. The most common complications of proximal phalanx fracture are the extensor lag and stiffness at the proximal interphalangeal joint, which leads to poor outcomes. Poor treatment compliance has also been identified among our patients. The target focused exercise regime with early controlled active mobilization should improve outcomes and treatment compliance among our patients. In this observational study with recruited 13 subjects, subjects age group range from 25 to 55 yrs. Baseline assessment was administrated for all the subjects. At 12 weeks the patient was re-assessed for Total Active Motion (TAM), Total Passive Motion (TPM), pain, grip strength, and Michigan Hand outcome measure. The TAM increase was statistically significant at P ≥ 0.01 within 4th, 6th, 8th, 10th, and 12th week. The TPM increase was statistically significant at P ≥ 0.01 between 8th, 10th, and 12th week. The mean satisfaction score was 91%. The mean extensor lag was 0.42°. The mean grip strength of the affected hand was 90.6% compared to that of the unaffected hand. The early controlled mobilization combined with target focused exercise regime was effective in improving the TAM and treatment compliance.
掌骨和指骨骨折是上肢常见的骨折。近节指骨骨折最常见的并发症是伸肌滞后和近节指间关节僵硬，导致预后不良。我们的患者中也存在治疗依从性差的问题。有针对性的集中练习方案和早期的主动关节活动度训练，应该可以改善我们的患者的预后和治疗依从性。在这项观察性研究中，共招募了 13 名受试者，年龄在 25 岁至 55 岁之间。所有受试者都进行了基线评估。在 12 周时，对患者的总主动活动度（TAM）、总被动活动度（TPM）、疼痛、握力和密歇根手功能测量进行了重新评估。TAM 在第 4、6、8、10 和 12 周内的增加具有统计学意义（P≥0.01）。TPM 在第 8、10 和 12 周之间的增加具有统计学意义（P≥0.01）。平均满意度评分为 91%。平均伸肌滞后为 0.42°。与未受伤的手相比，受伤手的平均握力为 90.6%。早期的主动关节活动度训练结合有针对性的集中练习方案，在改善 TAM 和治疗依从性方面是有效的。
