Adolfsson L, Söderberg G, Larsson M, Karlander L E
Department of Plastic Surgery, University Hospital, Linköping, Sweden.
J Hand Surg Br. 1996 Feb;21(1):67-71. doi: 10.1016/s0266-7681(96)80016-7.
The effects of a shortened post-operative mobilization programme following flexor tendon repair in zone 2 in the hand were examined in a prospective, randomized study. 91 digits in 82 patients were included in the study. All injured tendons were repaired within 24 hours and all patients were subjected to the same mobilization programme during the first 6 weeks using a passive flexion-active extension régime. After 6 weeks the patients were randomized into two groups; in group A full activity was allowed after 8 weeks while in group B unrestricted use of the injured hand was not allowed until 10 weeks after the tendon repair. Functional results were compared using the Louisville, Tsuge and Buck-Gramcko assessment systems. Grip-strength was measured 16 weeks after repair, subjective assessment of hand function was recorded on a visual analogue scale, and absence from work was registered. No significant differences were observed between the groups regarding functional results, rupture rates, grip strength or subjective assessment, but absence from work was reduced by 2.1 weeks with the shorter mobilization programme. Using the described régime, full activity can be encouraged 8 weeks after flexor tendon repair in zone 2 of the hand without adverse effects on functional results or increased risk of rupture of the repair.
在一项前瞻性随机研究中,对手部2区屈肌腱修复术后缩短活动方案的效果进行了检查。该研究纳入了82例患者的91根手指。所有受伤肌腱均在24小时内进行了修复,并且在头6周内所有患者都采用被动屈曲-主动伸展方式接受相同的活动方案。6周后,患者被随机分为两组;A组在8周后允许完全活动,而B组在肌腱修复后10周之前不允许对手部受伤部位进行无限制使用。使用路易斯维尔、津下和巴克-格拉姆科评估系统比较功能结果。在修复后16周测量握力,使用视觉模拟量表记录对手部功能的主观评估,并记录缺勤情况。在功能结果、破裂率、握力或主观评估方面,两组之间未观察到显著差异,但缩短活动方案使缺勤时间减少了2.1周。采用所述方案,手部2区屈肌腱修复术后8周可鼓励完全活动,而不会对功能结果产生不利影响,也不会增加修复部位破裂的风险。