手部多功能电动牵引支具的临床应用

The Clinical Application of Multifunctional Electric Traction Brace in Hand Surgery

手部多功能电动牵引支具由机械和电子两部分构成。它具有多功能、多用途、多项调节等特点，可作为固定器、牵引器和练功器使用，治疗手部的关节骨折脱位、关节挛缩和肌腱粘连等疾病。天津医院及大连２１０医院从１９９２年１月～１９９３年１１月应用于关节松解术后１５例２１指，结果优１７指，良４指；手指鞘内屈肌腱缝合及游离肌腱移植术后６例，优２例，良４例；屈肌腱松解术后３例，均为优；近侧指骨或中节指骨基底骨折、脱位４例５指，优４指，良１指。总共应用的３５指中，优２６指，良９指。由于此支具以电机为动力持续被动活动，活动速度缓慢、均匀，并有一定的牵引力，因此患者基本上无痛苦。对于屈肌腱粘连合并关节挛缩的病例可以一期手术解决。静止期可将患指固定在生理位，避免了各种弹性支具所易产生的关节囊挛缩的后遗症。

The multifunctional electric traction brace was composed of two parts, the electronic and mechanical. It has the special feature of versality and is adjustable for multiple purposes. The device can be used for fixation and traction, as well as an apparatus aiding functional exercise. It can be used for the treatment of fracture and dislocation of the hand, joint contractures and tendonous adhesions. From January 1992 to November 1993, arthrolysis was done in 15 cases (21 fingers) in Tianjin hospital and 210 PLA hospital in Dalian. Excellent results were obtained in 17 cases and good in 4. Flexor tenorrhaphy with free tendon graft inside the tendon sheath was done in 6 fingers and the results was excellent in 2 cases, good in 4 cases. Flexor tendolysis was done in 3 cases and the brace was used in aiding postoperative exercise, giving excellent results. Proximal or midphalangeal fractures in 4 cases(5 fingers) were treated with the brace and excellent result were seen in 4 fingers and good in one. Totally, 35 fingers were treated with the brace and the excellent result were seen in 26, good in 9. Continuous passive motion of the injuried fingers under traction caused no pain to the patients. For the cases of flexor tendon adhension combined with contracture of the joint capsule,surgical correction can be done in the same setting. In the static stage, the injuried fingers could be fixed in the physiological position and the sequelae of joint capsule contracture following the use of various elasticity brace can be avoided.