Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Rehabilitation and Technical Aids Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2021 Aug 1;84(8):795-798. doi: 10.1097/JCMA.0000000000000568.
Static progressive orthosis is used for the treatment of severe joint contracture after trauma and/or surgery. However, a custom-fabricated static progressive splint would be expensive and labor intensive. Especially, owing to very limited payment under the current Taiwanese National Health Insurance, the incentives to fabricate a patient-specific splint are insufficient for a therapist. To ease splint construction, we introduced three-dimensional (3D)-printed "shark fin"-shaped device works as a static progressive orthosis for the hand rehabilitation. The aim of this study was to describe and demonstrate the newly designed device.
This study included a 46-year male suffered from a left distal radius fracture and underwent open reduction internal fixation and a 23-year male with the right thumb flexor pollicis longus rupture, requiring tendon repair. Both subjects used this "shark fin"-shaped device to stretch for increasing range of motion (ROM) of wrist extension and the thumb.
The patient receiving ulnar shortening surgery used this device to stretch for increasing ROM of wrist extension. The active ROM of wrist extension improved from 30° to 50°. The other patient with the right thumb flexor pollicis longus rupture suffered from thumb contracture; the ROMs of the metacarpophalangeal (MCP) joint and interphalangeal (IP) joint were 40°-55° and 20°-25°, respectively. After tenolysis surgery, his ROMs of the MCP and IP joints were improved to 10°-35° and 40°-65°, respectively. Following physical therapy by applying the device, his ROMs of the MCP and IP joints were further increased to 0°-40° and 25°-70°, respectively.
Incorporating the "shark fin"-shaped orthosis into hand rehabilitation increased the ROM of wrist extension for a patient with distal radius fracture and improved the ROM of the MCP and IP joints in another patient after tenolysis surgery.
静态渐进式矫形器用于治疗创伤和/或手术后严重的关节挛缩。然而，定制的静态渐进式夹板制作既昂贵又费工。特别是，由于台湾现行全民健康保险制度支付的金额非常有限，制作患者专用夹板对治疗师来说激励不足。为了简化夹板的制作，我们引入了三维（3D）打印的“鲨鱼鳍”形状的设备，作为手部康复的静态渐进式矫形器。本研究的目的是描述和展示新设计的设备。
本研究包括一名 46 岁男性，因左桡骨远端骨折接受切开复位内固定术；另一名 23 岁男性，右手拇指屈拇长肌腱断裂，需行肌腱修复术。两位患者均使用这种“鲨鱼鳍”形状的设备来拉伸以增加腕关节伸展和拇指的活动度（ROM）。
接受尺骨缩短手术的患者使用该设备来拉伸以增加腕关节伸展的 ROM。腕关节伸展的主动 ROM 从 30°改善至 50°。另一位因右手拇指屈拇长肌腱断裂而患有拇指挛缩的患者，掌指（MCP）关节和指间（IP）关节的 ROM 分别为 40°-55°和 20°-25°。经过肌腱松解手术后，他的 MCP 和 IP 关节的 ROM 改善至 10°-35°和 40°-65°。在应用该设备进行物理治疗后，他的 MCP 和 IP 关节的 ROM 进一步增加至 0°-40°和 25°-70°。
将“鲨鱼鳍”形矫形器纳入手部康复治疗中，增加了桡骨远端骨折患者腕关节伸展的 ROM，改善了肌腱松解手术后 MCP 和 IP 关节的 ROM。
