手指锁定训练对2-5指屈肌腱Ⅱ区断裂术后粘连康复的疗效观察

Observation of the effect of finger blocking exercises on the rehabilitation of adhesions after rupture of 2-5 finger flexor tendon in zone Ⅱ

目的:探讨手指锁定训练对2-5指屈肌腱II区断裂术后粘连康复的疗效。方法:选取手部2-5指屈肌腱II区断裂修复术后粘连患者43例,按照随机数字法分成观察组21例(33指),对照组22例(36指)。两组患者在常规康复治疗方案基础上,观察组进行手指锁定训练,对照组做常规手指主动屈伸训练,治疗7周。分别在治疗前、治疗后评估手指关节总主动活动度(TAM),上肢功能评分(DASH)以及治疗后患指对拇指捏力并计算其相较健侧指捏力的百分比。结果:两组患者TAM、DASH在治疗前差异无统计学意义,在治疗后,观察组优良率为84.8%(28/33),对照组优良率为52.8%(19/36),差异有统计学意义(χ^(2)=8.757,P<0.05)。观察组TAM为232.73°±28.87°,PIP为74.36°±13.57°,DIP为69.39°±15.20°,对照组TAM为192.75°±35.47°,PIP为55.75°±17.13°,DIP为47.78°±18.51°,差异有统计学意义(P<0.05),观察组MP为88.97°±3.26°,对照组MP为89.22°±2.84°,差异无统计学意义(P>0.05)。观察组和对照组的DASH值较治疗前均有降低,差异有统计学意义(P<0.05),观察组DASH值低于对照组,差异有统计学意义(P<0.05)。观察组指捏力为(6.85±2.12)Lbs,对照组指捏力为(5.40±1.70)Lbs,差异有统计学意义(P<0.05)。观察组指捏力百分比为(82.07±7.43)%,对照组指捏力百分比为(70.22±7.92)%,差异有统计学意义(t=6.400,P=0.001)。结论:手指锁定训练能够显著改善2-5指屈肌腱II区断裂术后粘连患者的主动活动范围与指捏力,有效改善患者上肢活动功能,治疗效果良好。

Objective: To investigate the effect of blocking exercises on the rehabilitation of adhesions after rupture of 2-5 finger flexor tendon in zone Ⅱ. Methods: Forty-three patients with adhesions after repairing the rupture of the flexor tendon zone Ⅱ of the hand 2-5 fingers were selected and divided into 21 cases(33 fingers) in the observation group and 22 cases(36 fingers) in the control group according to the random number method. On the basis of conventional rehabilitation treatment, the observation group received finger blocking exercises, and the control group received conventional active finger flexion and extension training for 7 weeks. The total active motion(TAM) of the finger joints, the disability of arm shoulder and hand(DASH), and the pinch force of the affected finger to the thumb were evaluated and the comparison was calculated. Results: There was no significant difference between the two groups of patients in TAM and DASH before treatment. After treatment, the excellent and good rate of the observation group was 84.8%(28/33), and the excellent and good rate of the control group was 52.8%(19/36), the difference was statistically significant(χ^(2)=8.757, P<0.05). Observation group TAM is 232.73°±28.87°, PIP is 74.36°±13.57°, DIP is 69.39°±15.20°, control group TAM is 192.75°±35.47°, PIP is 55.75°±17.13°, DIP is 47.78°±18.51°, the difference was statistically significant(P<0.05), the MP of the observation group was 88.97°±3.26°, and the MP of the control group was 89.22°±2.84°, the difference was not statistically significant(P>0.05). The DASH values of the observation group and the control group were lower than before treatment, and both were statistically significant(P<0.05). The DASH value of the observation group was lower than that of the control group, and the difference was statistically significant(P<0.05). The finger pinch force of the observation group was(6.85±2.12) Lbs, and the finger pinch force of the control group was(5.40±1.70) Lbs, and the difference was statistically significant(P<0.05). The percentage of finger pinch force in the observation group was(82.07±7.43)%, and the percentage of finger pinch force in the control group was(70.22±7.92)%. There were statistical differences between the two groups(t=6.400, P=0.001). Conclusion: Finger blocking exercises can significantly improve the active range of motion and finger pinching force of patients with adhesions after 2-5 finger flexor tendon rupture in zone Ⅱ, and effectively improve the upper limb function of patients. The treatment effect is good.