Chow J A, Thomes L J, Dovelle S, Monsivais J, Milnor W H, Jackson J P
Department of Orthopaedics, Walter Reed Army Medical Center, Washington, DC.
J Bone Joint Surg Br. 1988 Aug;70(4):591-5. doi: 10.1302/0301-620X.70B4.3403603.
We present a system for treatment by controlled motion after repair of flexor tendons in the hand. This Washington regimen incorporates both controlled active extension against passive flexion by rubber band and the use of controlled passive extension and flexion. We utilise the Brooke Army Hospital modification of the rubber band passive flexion splint; this provides for maximal excursion of the tendon with full passive flexion of the finger. The 66 patients (78 fingers) who form the basis of this study all sustained complete laceration of the flexor profundus and superficialis tendons in "no man's land". Results were evaluated by the Strickland formula of total active motion (TAM) of the proximal and distal interphalangeal joints. Sixty-two fingers (80%) were rated "excellent", 14 fingers (18%) were "good", two fingers (2%) were "fair", none was rated "poor". Our regimen of controlled motion rehabilitation has also been applied with equal success to cases of flexor tendon grafting.
我们介绍一种手部屈肌腱修复后通过控制性运动进行治疗的系统。这种华盛顿疗法结合了利用橡皮筋进行的对抗被动屈曲的控制性主动伸展以及控制性被动伸展和屈曲的运用。我们采用了布鲁克陆军医院对橡皮筋被动屈曲夹板的改良；这能在手指完全被动屈曲时使肌腱实现最大程度的活动。构成本研究基础的66例患者（78根手指）均在“无人区”发生了屈指深肌腱和浅肌腱的完全断裂。结果通过近端和远端指间关节总主动活动度（TAM）的斯特里克兰德公式进行评估。62根手指（80%）评定为“优”，14根手指（18%）为“良”，两根手指（2%）为“中”，无手指评定为“差”。我们的控制性运动康复方案在屈肌腱移植病例中同样成功应用。
