手外伤患者术后各关节活动范围及力量对其手功能恢复影响的研究

To explore the effects of the range of motion and strength of each joint in patients with hand trauma on the recovery of hand injury

目的探讨手外伤患者术后各关节活动范围及力量对其手功能恢复的影响。方法选取2018年6月至2020年6月本院手足外科100例手术治疗的手外伤住院患者,观察其手功能恢复情况,分析评估患者手指关节总主动活动度、拇指对指功能及握力和捏力,采用Jebsen手功能测试量表评估手功能,开展相应的线性相关性分析。结果100例患者拆线时间(12.61±2.89)d,拇指对指功能评分(4.29±0.47)分,握力(12.64±2.43)kg。写字时间和拇指总主动活动度(TAM)及拇指对指评呈负相关(P<0.05);翻纸牌时间和拇指TAM呈负相关(P<0.05);拣小物时间和拇指TAM、食指TAM、中指TAM、环指TAM及拇指对指评分呈负相关(P<0.05);模拟进食时间和食指TAM及中指TAM呈负相关(P<0.05);叠棋子时间和食指TAM、中指TAM及拇指对指评分呈负相关(P<0.05);拿起大的轻罐子时间和拇指TAM、中指TAM及前臂旋前呈负相关(P<0.05);拿起大的重罐子时间和拇指TAM呈负相关(P<0.05)。拇指活动范围和指评分、握力及捏力呈正相关(P<0.05);食指活动范围和握力及捏力呈正相关(P<0.05);中指活动范围和握力呈正相关(P<0.05);环指活动范围和对指评分以及握力呈正相关(P<0.05);小指活动范围和对指评分及握力呈正相关(P<0.05)。结论手外伤患者的手功能恢复可受各关节活动范围以及力量的影响,对指功能以及拇指活动度是其术后康复恢复的重点,同时合理的力量训练可在一定程度上帮助患者恢复各指关节活动范围。

Objective To analyze the effects of the range of motion and strength of each joint in patients with hand trauma on the recovery of hand function.Methods 100 inpatients with surgically treated hand trauma were randomly selected from the hand and foot surgery ward of our hospital from June 2018 to June 2020 to observe the recovery of hand function and analyze and evaluate the total active range of motion of the patient's finger joints,thumb to finger function and grip strength and pinch strength.At the same time,its hand function is evaluated by the Jebsen hand function test scale,and the corresponding linear correlation analysis is carried out.Results The mean time of suture removal in 100 patients was(12.61±2.89)d;the mean score of thumb-to-finger function was(4.29±0.47)scores;the mean grip strength was(12.64±2.43)kg.Writing time is negatively correlated with thumb TAM and thumb-to-finger ratings;card flipping time is negatively correlated with thumb TAM(P<0.05);small object picking time is negatively correlated with thumb TAM,index finger TAM,middle finger TAM,ring finger TAM,and thumb-to-finger score(P<0.05);simulation eating time is negatively correlated with index finger TAM and middle finger TAM(P<0.05);time to stack pieces is negatively correlated with index finger TAM,middle finger TAM,and thumb-to-finger score(P<0.05);picking up a large light jar is negatively correlated with thumb TAM,middle finger TAM,and forearm pronation(P<0.05);there was a negative correlation between the time to pick up a large heavy jar and the thumb TAM(P<0.05).The range of thumb activity is positively correlated with finger score,grip strength and pinch strength(P<0.05);the range of index finger activity is positively correlated with grip strength and pinch strength(P<0.05);the range of middle finger activity is positively correlated with grip strength(P<0.05);the scope of ring finger activity is positively correlated with finger score and grip strength(P<0.05);The range of motion of the little finger was positively correlated with the score of the finger and the grip strength(P<0.05).Conclusion The recovery of hand function of patients with hand trauma can be affected by the range of motion and strength of each joint,finger function and thumb motion are the focus of their postoperative rehabilitation,at the same time,reasonable strength training can help patients recover the range of motion of each finger joint to certain extent.