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II区屈肌腱损伤修复术后早期与晚期主动活动的活动范围比较:一项随机临床试验

Comparison the Range of Motion Following Early Versus Late Active Mobilization after Repairing Surgery on Flexor Tendon Injury in the Zone II: A Randomized Clinical Trial.

作者信息

Abdolrazaghi Hosseinali, Ramin Mohammad, Molaei Hojjat

机构信息

Hand & Reconstructive Surgery Department, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Plastic & Reconstructive Surgery Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

World J Plast Surg. 2023;12(2):29-33. doi: 10.52547/wjps.12.2.29.

Abstract

BACKGROUND

Early or delayed mobilization of limb after flexor tendon rupture repairing has an effect on postoperative outcomes, however it is not yet clear whether early or late organ mobilization leads to more likelihood of recovery. We aimed to assess the effects of early and late active limb mobilization through rehabilitation after surgery on the range of motion and hand recovery.

METHODS

This randomized clinical study was performed in Sina Hospital, Tehran, Iran in 2022 on 80 patients with flexor tendon damage in the zone II, who underwent reconstructive surgery of superficial and deep tendons. Patients were randomly (using random number table) divided into two groups that for one group, rehabilitation was done early (starting after three days, n = 53) and for the other group, rehabilitation was done late (starting after three weeks, n = 27). The patients were examined postoperatively and following occupational therapy and the range of motion of their involved joints was calculated.

RESULTS

The means PIP extension Lag, PIP active flexion, DIP extension Lag, DIP active flexion and total active motion were all significantly higher in those patients planned for early mobilization as compared to those who considered for late mobilization(=0.031). Such a significant difference was also revealed adjusting baseline parameters.

CONCLUSION

Compared to the delayed start of hand flexor tendon mobility, the early start of these activities is associated with a much greater improvement in the movement function of this tendon.

摘要

背景

屈指肌腱断裂修复术后早期或延迟进行肢体活动对术后结果有影响,然而,早期或晚期进行肢体活动是否更有利于恢复尚不清楚。我们旨在评估术后通过康复进行早期和晚期主动肢体活动对关节活动范围和手部恢复的影响。

方法

2022年,在伊朗德黑兰的西娜医院对80例Ⅱ区屈指肌腱损伤且接受了浅、深肌腱重建手术的患者进行了这项随机临床研究。患者被随机(使用随机数字表)分为两组,一组早期进行康复(术后三天开始,n = 53),另一组晚期进行康复(术后三周开始,n = 27)。术后对患者进行检查,并在职业治疗后计算其患侧关节的活动范围。

结果

与晚期活动的患者相比,计划早期活动的患者的近端指间关节(PIP)伸展滞后、PIP主动屈曲、远端指间关节(DIP)伸展滞后、DIP主动屈曲以及总主动活动的均值均显著更高(P = 0.031)。在调整基线参数后,也显示出如此显著的差异。

结论

与延迟开始手部屈指肌腱活动相比,早期开始这些活动与该肌腱的运动功能有更大改善相关。

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