Evans R B
Indian River Hand Rehabilitation, Vero Beach, Florida, USA.
Hand Clin. 1995 Aug;11(3):483-512.
Postoperative management of the extensor tendon injury has been altered over the past 15 years from treatment with 4 to 6 weeks of immobilization to controlled passive motion and, now, to active SAM with minimal tension and wrist tenodesis programs. The concepts of immediate motion are supported biochemically in experimental studies, and biomechanically through excursion studies, mathematical analysis of tendon excursion and force application, and study of repair tensile strengths. The results cited in this article and those reported by others demonstrate that early motion for extensor tendons in zones III, IV, V, VI, VII, T IV, and T V is safe and effective if force application is precise. Early referral to therapy, meticulous care in the control of edema, precise positions of postoperative splinting, and controlled motion programs will greatly improve the results of both simple and complex extensor tendon injuries, both in terms of function achieved and in terms of time and expense.
在过去15年中，伸肌腱损伤的术后管理已发生变化，从固定4至6周的治疗方式转变为控制性被动活动，现在又转变为最小张力下的主动静态辅助运动（SAM）和腕关节动力腱固定程序。即时活动的概念在实验研究中得到生物化学支持，在生物力学上则通过活动度研究、肌腱活动度和力施加的数学分析以及修复拉伸强度研究得到支持。本文引用的结果以及其他人报告的结果表明，如果力的施加精确，Ⅲ区、Ⅳ区、Ⅴ区、Ⅵ区、Ⅶ区、T Ⅳ区和T Ⅴ区伸肌腱的早期活动是安全有效的。早期转诊至理疗、精心控制水肿、术后夹板固定的精确位置以及控制性活动程序，将在功能实现、时间和费用方面大大改善单纯和复杂伸肌腱损伤的治疗效果。
