自制三维力学伸指支具对指间关节伸展受限的疗效

The Effect of Homemade Three dimensional Mechanical Splinting to the Interphalangeal Joint with Stretching Limited

目的：研究对指间关节伸展受限的患者分别予以佩戴自制三维力学伸指支具、静态进展型支具后，两者的疗效情况；探索支具制作新的理论依据，即三维力学原理，以避免以3点力学为理论依据设计的支具所带来的并发症。方法：2例指间关节伸展受限的患者随机分为观察组和对照组，观察组1例，1个关节，对照组1例，1个关节，2组均行常规系统康复治疗并分别佩戴静态进展型、自制三维力学支具。在治疗前、治疗4周、8周后采用被动关节活动范围、疼痛和综合伸指功能简易评定，并进行统计学分析。结果：治疗后2组患者的被动关节活动范围和综合伸指功能均有改善（P〈0．05），观察组优于对照组（P〈0．05），在疼痛方面，观察组轻于时照组，差异有统计学意义（P〈0．01）。结论：以三维力学为理论依据设计的支具较传统以3点力学为理论依据设计的支具在僵硬关节的矫正方面更有优势，包括疗效和并发症两方面。

Objectiv： To observe the effect of wearing homemade three dimensional splinting and static progressive splinting respectively in patients with the stretching limited interphalangeal joint; Explore a new theoretical basis of mading splinting , namely three dimensional mechanics principle, and to avoid the complications along with the splinting with three point mechanics as the theoretical basis for design. Methods： 1 patients with the stretching limited interphalangeal joint were divided randomly into experimental group and control group. The control group include 1 joint of 1 patients, the experimental group include 1 joint of 1 patients. Both groups were giving routine rehabilitation treatment systemly and wearing homemade three dimensional splinting and static progressive splinting respectively. Use passive range of joint, pain and the comprehensive and simple finger stretching function assessment before treatment, treatment after 4 weeks and 8 weeks, then make a statistical analysis. Results： Two groups were improved in the passive joint range and the comprehensive and simple finger stretching function after treatment（ P 〈 0.05 ）, the experimental group is better than the control group （ P 〈 0.05 ）, in terms of pain, patients in the experimental group were lighter than the control group,the difference was meaningful in statistics （P 〈 0. 01 ） Conclusion ： The three dimensional splinting with three dimensional mechanics as the theoretical basis for design have more advantages than the splinting with three point mechanics as the theoretical basis for design, including the aspects of curative effect and complications.