Miller Jonathan E, Le Brian Q
Division of Plastic and Reconstructive Surgery, Virginia Commonwealth University Health System, Richmond, Va.
Plast Reconstr Surg Glob Open. 2022 Mar 29;10(3):e4211. doi: 10.1097/GOX.0000000000004211. eCollection 2022 Mar.
Lacerations to the dorsum of the hand are frequently complicated by involvement of extensor tendons. Bedside repair of these injuries in the emergency room decreases time to treatment and avoids operating room expenses and anesthetic associated risks. Optimal outcomes require prompt follow-up and initiation of hand therapy to promote tendon gliding and prevent tethering of scar tissue. Here, we present our improvised relative motion extension splint utilized in treatment of zone five and six extensor tendon lacerations. This orthosis is preferred in isolated extensor tendon injuries that are amenable to primary repair at the bedside in the appropriately compliant and motivated patient. Our design is comprised of readily available supplies in the emergency room setting. Our improvised relative motion extension splint is lighter weight versus a traditional plaster orthosis and frees the patient to engage in activities of daily living with the injured hand on day four following tendon repair. With repeated application we have become facile with this design, which also permits flexibility such as placement of a wrist extension splint component if needed. Relative motion extension splinting is an established method of treatment following extensor tendon repair. Here, we present a straightforward method of fabricating such a device in the emergency room without the availability of thermoplastic materials. Future study will be needed to establish the efficacy of this device versus its thermoplastic counterpart.
手背撕裂伤常因伸肌腱受累而变得复杂。在急诊室对这些损伤进行床边修复可缩短治疗时间，并避免手术室费用和麻醉相关风险。最佳治疗效果需要及时随访并开始手部治疗，以促进肌腱滑动并防止瘢痕组织粘连。在此，我们介绍我们自行制作的相对运动伸展夹板，用于治疗五区和六区伸肌腱撕裂伤。对于适合在床边进行一期修复的、依从性良好且积极性高的患者，这种矫形器在单纯伸肌腱损伤中更为适用。我们的设计由急诊室中容易获得的材料组成。与传统石膏矫形器相比，我们自行制作的相对运动伸展夹板重量更轻，在肌腱修复后的第四天即可让患者使用受伤的手进行日常生活活动。通过反复应用，我们对这种设计已经得心应手，并且如果需要，它还允许灵活性，例如放置手腕伸展夹板组件。相对运动伸展夹板固定是伸肌腱修复后的一种既定治疗方法。在此，我们介绍一种在没有热塑性材料的情况下在急诊室制作这种装置的简单方法。未来需要进行研究以确定该装置与其热塑性同类产品相比的疗效。
