Kim Dae-Geun, Choi Sung, Park Eugene J
Department of Orthopedic Surgery, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine, 179 1Gongdan-ro, Gumi, 39371, South Korea.
Department of Orthopedic Surgery, Daegu Fatima Hospital, Daegu, South Korea.
BMC Musculoskelet Disord. 2024 Oct 1;25(1):767. doi: 10.1186/s12891-024-07899-9.
Extensor tendon injuries require surgical repair, followed by rehabilitation to ensure optimal outcomes. Immobilization has been the cornerstone of postoperative management. However, immobilization after surgery frequently makes the finger stiffness, often resulting in reduced functionality and quality of life for patients. Recent studies indicate that early controlled motion can significantly improve outcomes, but safe early range of motion (ROM) exercise is a significant clinical challenge. This article aims to check the efficacy of the novel designed finger ROM brace for preventing finger stiffness for extensor tendon injuries with case series.
A finger ROM brace was designed based on the natural finger movement. Like a real finger, there are two tiny hinge joints and three round-shape body components. The design aimed to be ergonomic dynamic splint assisting controlled motion to promote early motion, thus reducing tendon tension and preventing stiffness. Elastic resistant ROM exercise could be by inserting a silicone band into the groove on the components and free movement could be achieved by removing a silicone band.
Between December 2022 and July 2023, 10 patients who underwent tenorrhaphy because of extensor tendon laceration were involved. Complete extensor tendon laceration was 3 patients, other seven patients had partial laceration of extensor tendons. Surgery was performed within 2 days of injury, and no infection was observed in all patients. After the extensor tendon was confirmed as healed state by ultrasound, the patients were permit the active exercise wearing finger ROM brace with a silicone band. Within 1-2 weeks after elastic resistant exercise, the patients could achieve free full ROM movement without any complication.
The novel finger ROM brace combines the advantages of dynamic splinting and under-actuated mechanisms to offer a comprehensive solution for preventing stiffness after extensor tendon suture. Future studies should focus on clinical trials to validate the efficacy and safety of this brace in a larger population.
伸肌腱损伤需要手术修复，随后进行康复治疗以确保最佳疗效。固定一直是术后管理的基石。然而，术后固定常常导致手指僵硬，常使患者的功能和生活质量下降。最近的研究表明，早期控制运动可显著改善疗效，但安全的早期活动范围（ROM）锻炼是一项重大的临床挑战。本文旨在通过病例系列研究新型设计的手指ROM支具预防伸肌腱损伤后手指僵硬的疗效。
基于手指的自然运动设计了一种手指ROM支具。它类似真实手指，有两个微小的铰链关节和三个圆形主体部件。该设计旨在成为一种符合人体工程学的动态夹板，辅助控制运动以促进早期活动，从而减少肌腱张力并防止僵硬。通过在部件的凹槽中插入硅胶带可进行弹性阻力ROM锻炼，移除硅胶带则可实现自由活动。
在2022年12月至2023年7月期间，纳入了10例因伸肌腱撕裂而接受肌腱缝合术的患者。完全伸肌腱撕裂的有3例患者，其他7例患者为伸肌腱部分撕裂。受伤后2天内进行了手术，所有患者均未观察到感染。在超声确认伸肌腱处于愈合状态后，允许患者佩戴带有硅胶带的手指ROM支具进行主动锻炼。在弹性阻力锻炼后的1 - 2周内，患者能够实现自由的全ROM运动且无任何并发症。
新型手指ROM支具结合了动态夹板和欠驱动机制的优点，为预防伸肌腱缝合后僵硬提供了一种综合解决方案。未来的研究应聚焦于临床试验，以在更大规模人群中验证该支具的疗效和安全性。
