Prosser R
Sydney Hand Therapy and Rehabilitation Centre, St. Luke's Hospital Hand Unit, Sydney, Australia.
J Hand Ther. 1996 Oct-Dec;9(4):378-86. doi: 10.1016/s0894-1130(96)80045-7.
Proximal interphalangeal (PIP) flexion contracture is a common complication following hand injuries and conditions. This study investigated the treatment outcome of 20 subjects with PIP flexion contracture who followed a dynamic splinting program using either a Capener or low-profile outrigger. The splint applied a 250-g force to the distal end of the middle phalanx. Each patient was instructed to wear the splint for 8 to 12 hours per 24 hours for 8 weeks followed by a 2- to 3-week weaning period. Passive extension was evaluated objectively using torque range-of-motion measurement. The average pretreatment flexion contracture was 39 degrees. Final extension deficit averaged 21 degrees, an improvement of 18 degrees. There was no statistically significant effect on final results based on joint stiffness (as expressed by the slopes of the torque angle curves). Total end-range time (TERT) averaged 10 hours per 24 hours, for an average period of 4.3 months. Statistical analysis showed that splinting time was the only statistically significant factor affecting outcome. The correlation coefficients showed that the longer the contracture was present, the stiffer the joint and the less the contracture resolved. Dynamic splinting was an effective form of treatment for PIP flexion contracture.
近端指间关节（PIP）屈曲挛缩是手部损伤和疾病后的常见并发症。本研究调查了20例PIP屈曲挛缩患者采用Capener或低轮廓支具进行动态夹板治疗的结果。夹板对中节指骨远端施加250克的力。每位患者被指示每24小时佩戴夹板8至12小时，持续8周，随后是2至3周的逐渐停用期。使用扭矩运动范围测量客观评估被动伸展情况。治疗前平均屈曲挛缩为39度。最终伸展缺损平均为21度，改善了18度。基于关节僵硬程度（由扭矩角度曲线的斜率表示），对最终结果没有统计学上的显著影响。每24小时总终末范围时间（TERT）平均为10小时，平均持续时间为4.3个月。统计分析表明，夹板佩戴时间是影响结果的唯一具有统计学意义的因素。相关系数表明，挛缩存在的时间越长，关节越僵硬，挛缩缓解的程度越小。动态夹板是治疗PIP屈曲挛缩的一种有效治疗方式。
