Hebeshi Nourhan, El-Gazzar Nagat, El-Barbary Amal, El-Hawa Marwa Abo
Department of Rheumatology and Rehabilitation, Faculty of Medicine, Tanta University, Geish Street, Tanta, Gharbia, Egypt.
Turk J Phys Med Rehabil. 2023 Feb 2;69(1):61-68. doi: 10.5606/tftrd.2023.9376. eCollection 2023 Mar.
This study aimed to evaluate the contribution of musculoskeletal ultrasound to the follow-up of surgically repaired hand tendons during rehabilitation programs and correlate ultrasound findings with the clinical outcome.
In the prospective observational study, 40 patients (29 males, 11 females; mean age: 27.4±10.7 years; range, 15 to 55 years) who presented with postoperative hand tendon repair between January 2019 and March 2020 were randomized into two groups: Group 1 included 15 subjects with 16 repaired flexor tendons, whereas Group 2 consisted of 25 subjects with repaired extensor tendons. Afterward, the assessment was performed at the four, eight, and 12 weeks of rehabilitation utilizing the total active motion of injured fingers, Visual Analog Scale (VAS), grip strength, ultrasound, and hand assessment tool (HAT).
The study's findings revealed a substantial improvement in pain based on the evaluation of grip strength, total active motion, VAS, and the affected hand's HAT score in both groups (p<0.001). In both groups, ultrasonographic evaluation of healing tendons revealed considerable enhancement in margination, defect size, thickness, echogenicity, and vascularity. A positive correlation was detected between VAS and healing tendon margination as well as the HAT score and handgrip margination in Group 1.
High-frequency ultrasound is an easily accessible modality in the follow-up and evaluation of tendon healing after surgical repair and during a rehabilitation program.
本研究旨在评估肌肉骨骼超声在手部肌腱手术修复后康复计划中的随访作用，并将超声检查结果与临床结局相关联。
在这项前瞻性观察研究中，将2019年1月至2020年3月间接受手部肌腱修复术后的40例患者（29例男性，11例女性；平均年龄：27.4±10.7岁；范围15至55岁）随机分为两组：第1组包括15名受试者，有16条修复的屈指肌腱，而第2组由25名修复伸指肌腱的受试者组成。之后，在康复的第4、8和12周进行评估，采用受伤手指的总主动活动度、视觉模拟量表（VAS）、握力、超声和手部评估工具（HAT）。
研究结果显示，两组患者在握力、总主动活动度、VAS以及患手的HAT评分评估中，疼痛均有显著改善（p<0.001）。两组中，对愈合肌腱的超声评估均显示边缘、缺损大小、厚度、回声和血管情况有显著改善。在第1组中，检测到VAS与愈合肌腱边缘以及HAT评分与握力边缘之间呈正相关。
高频超声是手术修复后及康复计划期间肌腱愈合随访和评估中一种易于获得的检查方式。
