前臂再植术后患者早期预防手内在肌挛缩的康复护理

Rehabilitation nursing of patients after forearm replantation to prevent contracture of intrinsic muscle of hand

报告了前臂离断再植术后预防手内在肌挛缩的康复训练过程和效果。对9例前臂离断再植术后患者在术后不同阶级采用不同的支具固定方法,进行相应的物理、作业疗法,预防前臂再植术后手内在肌挛缩。根据手关节活动范围系统评价标准,7例手功能恢复优,两点辨别觉5～10cm,触摸觉正常,握力30kg,相当于健侧手90%功能,中1例,差1例。本组仅1例行内在肌功能重建。

This paper introduces the rehabilitation methods and outcomes of patients after forearm replantation to prevent contracture of intrinsic muscle of hand. Nine patients with forearm replantation were treated by different orthosis for fixation and received physical therapy and occupational therapy to prevent contracture of intrinsic muscle of hand. Based on the test of finger joints functional recovery of hands（TAM） system,seven cases achieved to excellent grade of functional recovery;the two point discrimination of the finger pulp was 5-10cm;the touch sensation recovered to normal,the hand grip strength reached to 30kg,equal to 90% function of healthy side. One case achieved to good grade of functional recovery and one case was bad. Only one case was treated by functional reconstruction of hand intrinsic muscles.