Rennie H J
Occupational Therapy Department, Royal Perth Rehabilitation Hospital, Western Australia.
J Hand Ther. 1996 Oct-Dec;9(4):371-7. doi: 10.1016/s0894-1130(96)80044-5.
Rheumatoid arthritis (RA) causes structural damage that precipitates joint deformity, including metacarpophalangeal (MCP) joint ulnar drift (UD). Orthoses have been designed in order to maintain hand function by improving joint alignment, restoring biomechanical balance and reducing stress on supporting diseased tissues. This study investigated the impact an MCP UD (MUD) splint had on: pain, hand function, grip strength, and passive correction of UD when worn for function by RA patients. Twenty seven hands (26 subjects) were evaluated and performances compared with and without the splint. Results showed anatomic alignment improved significantly in all except the index finger. The mean difference for all fingers combined was 10 degrees. Observable correction of subluxation was identified from x-ray film and noted in 14.8% of index fingers, 18.5% of middle fingers, 33.3% of ring fingers, and 48.1% of little fingers. Three point pinch showed a statistically significant change, the mean difference being an improvement of 15% while wearing the splint. There was no significant change in hand function score, pain score, gross grip strength, and lateral pinch. Subjects' perceptions of the MUD splint gained from a questionnaire showed a high acceptance: 79.2% reporting minimal interference in ADL, 95.8% satisfied with cosmesis, 87.5% satisfied with comfort, and 95.8% reported continued use of the orthosis.
类风湿性关节炎（RA）会导致结构损伤，进而引发关节畸形，包括掌指（MCP）关节尺侧偏移（UD）。人们设计了矫形器，旨在通过改善关节对线、恢复生物力学平衡以及减轻患病支撑组织的压力来维持手部功能。本研究调查了MCP UD（MUD）夹板对类风湿性关节炎患者功能佩戴时的疼痛、手部功能、握力以及UD被动矫正的影响。对27只手（26名受试者）进行了评估，并比较了佩戴夹板和不佩戴夹板时的表现。结果显示，除食指外，所有手指的解剖对线均有显著改善。所有手指的平均差异为10度。从X光片上可观察到半脱位的矫正情况，食指为14.8%、中指为18.5%、无名指为33.3%、小指为48.1%。三点捏显示出统计学上的显著变化，佩戴夹板时平均差异改善了15%。手部功能评分、疼痛评分、总握力和侧捏力均无显著变化。通过问卷调查得出，受试者对MUD夹板的看法显示出高度接受度：79.2%的人表示对日常生活活动干扰最小；95.8%的人对外观满意；87.5%的人对舒适度满意；95.8%的人表示会继续使用该矫形器。
