方法:病例报告简介:相对运动屈曲(RMF)矫形器正在成为术后早期主动运动(EAM)的一种选择。
目的:描述RMF矫形器的基本原理和实施,以治疗II区表腱肌腱部分修复后的患者。
方法:该病例涉及一名女性,她在II区中指遭受部分屈肌腱撕裂,60%的指浅屈(FDS)和90%的指深屈(FDP)。在进行表皮修复后,她被转诊为EAM治疗,没有矫形器的要求。异常情况促使治疗师,担心肌腱断裂的风险与外科医生进行讨论。在讨论之后,决定使用RMF矫形器进行受控EAM,以保护第II区FDS和FDP修复。运动范围(ROM)的结果,总主动运动(TAM),%TAM,握把,和quickDASH报告。
结果:FDP或FDS肌腱均未破裂,也没有任何关节挛缩。术后12周达到“良好”%TAM结果。快速DASH评分提高了61分,表明功能改善的临床意义差异。
结论:缺乏与EAM结合使用的多股芯缝线修复是不寻常的。在该单个患者中报告的积极结果引起了人们对RMF矫形器与90%FDP裂伤的II区表皮修复一起使用时的保护性益处的疑问。部分(60%)FDS损伤的附睾修复,然而,并不罕见,而且经常根本不修理。
结论:在这个单例报告中,II区90%FDP和60%FDS受指神经累及的表皮修复成功地使用仅RMF矫形器进行了治疗。使用EAM进行表皮修复与当前的手术和治疗文献相冲突。
Case report INTRODUCTION: Relative motion flexion (RMF) orthoses are emerging as an option for early active motion (EAM) postoperatively.
To describe the rationale and implementation of an RMF orthosis to manage a patient after partial zone II epitendinous flexor tendon repairs.
This
case involves a female who sustained partial flexor tendon lacerations to her middle finger in zone II, 60% flexor digitorum superficialis (FDS) and 90% flexor digitorum profundus (FDP). After epitendinous repair she was referred to therapy for EAM with a no orthosis request. The unusual circumstances prompted the therapist, concerned about the risk of tendon rupture to engage in discussion with the surgeon. Following discussion, a decision was made to use an RMF orthosis for controlled EAM to protect the epitendinous zone II FDS and FDP repairs. Outcomes of range of motion (ROM), total active motion (TAM), %TAM, grip, and quickDASH are reported.
Neither the FDP or FDS tendons ruptured, nor were there any joint contractures. \"Good\" %TAM outcomes were achieved at 12-week postoperatively. Quick DASH scores improved 61 points indicating a clinically meaningful difference of improved function.
The lack of a multi-strand core suture repair is unusual in combination with EAM. The positive outcomes reported in this single patient have raised questions about the protective benefit of the RMF orthosis when used with a zone II epitendinous repair of a 90% FDP laceration. Epitendinous repair of a partial (60%) FDS injury, however, is not uncommon and often not repaired at all.
In this single
case report the epitendinous repairs of zone II 90% FDP and 60% FDS with digital nerve involvement were successfully managed with an RMF only orthosis. The use of EAM with an epitendinous repair is in conflict to the current surgical and therapy literature.