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三角纤维软骨复合体中央部修复术后康复指南:澳大利亚手和腕关节外科医生的调查。

Post-surgical Rehabilitation Guidelines for Triangular Fibrocartilage Complex Foveal Repair: A Survey of Australian Hand and Wrist Surgeons.

机构信息

Griffith University, Gold Coast, Australia.

Griffith University, Nathan, Australia.

出版信息

J Hand Surg Asian Pac Vol. 2024 Aug;29(4):302-308. doi: 10.1142/S2424835524500309. Epub 2024 Jul 12.

DOI:10.1142/S2424835524500309
PMID:39005178
Abstract

To restore distal radioulnar joint stability following injury to the Triangular Fibrocartilage Complex (TFCC), foveal repair surgery may be necessary. Post-surgery rehabilitation is prescribed to restore wrist and hand function; however, no universally accepted or definitive rehabilitation protocol currently exists. The aim of this study was to survey hand and wrist surgeons regarding their recommended postoperative rehabilitation protocols following TFCC foveal repair surgery. Australian hand and wrist surgeons were invited to complete a descriptive survey containing 10 questions. Questions included clinical recommendations for wrist and forearm immobilisation, range of motion (ROM) exercise timeframes and surgeon experience of TFCC rupture. Descriptive statistics and between-group (TFCC rupture vs. no-rupture) comparisons (Pearson's Chi) were calculated. Thirty-one surgeons completed the survey. Recommendations for post-surgery immobilisation ranged from 'not required' to 8 weeks (mode 6 weeks). Wrist and forearm ROM commencement time ranged from 'immediately' to 'later than 8 weeks' (mode 6 weeks). The most recommended orthosis was a 'sugar-tong' (57%). Thirty-seven percent (37%) reported experience of post-surgery re-rupture. While surgeon recommendations varied, the majority recommended 4- to 6-week timeframe for immobilisation and ROM exercise commencement. Additional clinical research is recommended to evaluate whether postoperative rehabilitation decisions influence patient outcomes. Level V (Therapeutic).

摘要

为了在三角纤维软骨复合体 (TFCC) 损伤后恢复远侧桡尺关节稳定性,可能需要进行窝状修复手术。手术后的康复治疗旨在恢复手腕和手部功能;然而,目前还没有普遍接受或明确的康复方案。本研究旨在调查手部和腕部外科医生在 TFCC 窝状修复手术后推荐的术后康复方案。邀请澳大利亚手部和腕部外科医生完成一份包含 10 个问题的描述性调查。问题包括对手腕和前臂固定、关节活动度 (ROM) 锻炼时间框架和外科医生 TFCC 破裂经验的临床建议。计算了描述性统计数据和组间(TFCC 破裂与无破裂)比较(Pearson's Chi)。31 名外科医生完成了调查。术后固定的建议范围从“不需要”到 8 周(模式 6 周)。手腕和前臂 ROM 起始时间范围从“立即”到“8 周后”(模式 6 周)。最推荐的矫形器是“糖夹”(57%)。37%的人报告有术后再破裂的经历。虽然外科医生的建议有所不同,但大多数人建议固定和 ROM 运动开始的时间为 4 到 6 周。建议进行更多的临床研究,以评估术后康复决策是否会影响患者的结果。等级 V(治疗)。

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