Nakanishi Risako, Sasaki Shuichi, Kamide Naoto, Takamori Sohei, Nakajima Yoshito, Matsumoto Satomi, Onuma Kenji, Sukegawa Koji, Otake Yuya, Takahira Naonobu
Department of Rehabilitation, Yokohama Minami Kyosai Hospital, Yokohama, JPN.
Graduate School of Medical Sciences, Kitasato University, Sagamihara, JPN.
Cureus. 2024 Nov 14;16(11):e73675. doi: 10.7759/cureus.73675. eCollection 2024 Nov.
The standard treatment for the conservative management of a proximal phalanx fracture of the little finger involves immobilizing the fracture site with a cast. However, cast immobilization presents challenges in maintaining hygiene during treatment and restricts the fine motor movements of the fingers. In this study, we developed a removable orthosis that immobilizes only the ring and little fingers. We examined the splint's effectiveness in joint immobilization and its impact on fine motor movements of the fingers.
Twenty healthy adults were included in this study conducted at the Yokohama Minami Kyosai Hospital, Yokohama, Japan. While wearing a cast and an orthosis, the range of motion of the metacarpophalangeal (MP) joints of the index and little fingers was measured using X-ray fluoroscopy. The Purdue Pegboard Test evaluated fine motor skills, handwriting tasks, and chopstick use tests. We statistically compared the range of motion and fine motor skills of the MP joints in the cast and orthosis.
The range of motion of the MP joint in the index finger was significantly greater with the orthosis than with the cast (p < 0.001). In contrast, in the little finger, the cast allowed a greater range of motion than the orthosis (p < 0.077). Additionally, regarding fine motor skills, in the chopstick task, the orthosis showed significantly better performance than the cast.
The developed orthosis, which immobilized only the ring and little fingers, provided sufficient stability to the little finger while maintaining the index finger's mobility. Additionally, it imposed minimal restrictions on fine motor movements and the use of chopsticks.
小指近节指骨骨折保守治疗的标准方法是用石膏固定骨折部位。然而，石膏固定在治疗期间保持卫生方面存在挑战，并且会限制手指的精细运动。在本研究中，我们开发了一种仅固定环指和小指的可摘除矫形器。我们研究了该夹板在关节固定方面的有效性及其对手指精细运动的影响。
本研究在日本横滨市南急救医院对20名健康成年人进行。在佩戴石膏和矫形器时，使用X线透视测量示指和小指掌指（MP）关节的活动范围。普渡钉板测试评估精细运动技能、书写任务和使用筷子测试。我们对石膏和矫形器中MP关节的活动范围和精细运动技能进行了统计学比较。
矫形器固定时示指MP关节的活动范围明显大于石膏固定时（p < 0.001）。相比之下，在小指中，石膏固定时的活动范围大于矫形器固定时（p < 0.077）。此外，在精细运动技能方面，在使用筷子任务中，矫形器的表现明显优于石膏。
所开发的仅固定环指和小指的矫形器在保持示指活动度的同时，为小指提供了足够的稳定性。此外，它对精细运动和使用筷子的限制最小。
