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近端指间关节屈曲挛缩的弹性张力数码氯丁橡胶矫形器的初步研究。

Preliminary study of elastic-tension digital neoprene orthoses for proximal interphalangeal joint flexion contracture.

机构信息

Hand Therapy Barcelona, C/Roger de Lluria 5, 08010 Barcelona, Spain; Unit of Human Anatomy and Embryology, University of Barcelona, C/Casanova 143, 08036 Barcelona, Spain; Gimbernat School of Physical Therapy, Avinguda de la Generalitat s/n, 08174 Sant Cugat del Vallès, Spain.

Senior Consulting Therapist: Karen Schultz Hand and Upper Limb Strategies (KSHULS), Spain.

出版信息

Hand Surg Rehabil. 2023 Feb;42(1):69-74. doi: 10.1016/j.hansur.2022.10.006. Epub 2022 Nov 3.

Abstract

Flexion contracture of the proximal interphalangeal joint (PIPJ) is one of the most frequent complications in finger trauma. Orthoses are the most widely used method to optimize total end-range time (TERT). No previous studies showed that an elastic tension orthosis could be applied for longer than 12 h. We aimed to demonstrate that the elastic-tension digital neoprene orthosis (ETDNO) can achieve higher TERT and therefore better range of motion than other elastic-tension orthoses (ETO) described in the literature. A prospective study of treatment of PIPJ flexion contracture included 10 PIP joints in 8 patients who met the selection criteria. They were instructed to use the ETDNO for around 23 h per day as far as possible, during a period of 3 weeks. Patients reported a mean TERT of 20.6 h a day. PIPJ contracture improved by a mean Torque Range of Motion (TROM) of 23.5° at 500 g and 22.9° at 800 g of passive extension force during the 3-week treatment. Based on the results of this study, the ETDNO appears to offer a highly effective approach for improving PIPJ flexion contracture, increasing range of motion in extension. ETDNO's efficacy probably lies in the significantly improved comfort and low-profile design, enabling excellent compliance and thus optimizing TERT. LEVEL OF EVIDENCE: Level III.

摘要

近节指间关节(PIPJ)屈曲挛缩是手指创伤最常见的并发症之一。矫形器是优化总末端范围时间(TERT)最广泛使用的方法。以前没有研究表明弹性张力矫形器可以应用超过 12 小时。我们旨在证明弹性张力数字氯丁橡胶矫形器(ETDNO)可以实现更高的 TERT,从而比文献中描述的其他弹性张力矫形器(ETO)获得更好的运动范围。一项关于 PIPJ 屈曲挛缩治疗的前瞻性研究包括 8 名符合选择标准的患者的 10 个 PIP 关节。他们被指示尽可能每天使用 ETDNO 约 23 小时,为期 3 周。患者报告每天 TERT 的平均时间为 20.6 小时。在 3 周的治疗过程中,PIPJ 挛缩在 500g 时平均改善了 23.5°的扭矩运动范围(TROM),在 800g 时平均改善了 22.9°的 TROM。根据这项研究的结果,ETDNO 似乎为改善 PIPJ 屈曲挛缩提供了一种非常有效的方法,增加了伸展时的运动范围。ETDNO 的疗效可能在于其显著提高的舒适性和低调设计,实现了出色的顺应性,从而优化了 TERT。证据水平:III 级。

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