Anatomic and Functional Improvements Achieved by Rehabilitation in Zone II and Zone V Flexor Tendon Injuries
Anatomic and Functional Improvements Achieved by Rehabilitation in Zone II and Zone V Flexor Tendon Injuries
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DOI：
10.1097/phm.0b013e3181fc7a46
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发表时间：
2011-01-01
影响因子：
3
通讯作者：
Oztan, Yucel
中科院分区：
文献类型：
--
作者：
Bal, Serpil;Oz, Bengi;Oztan, Yucel
目的：本研究的目的是比较 II 区和 V 区屈肌腱损伤的解剖学和功能改善情况，并确定损伤程度对残疾的影响。 设计：本研究纳入了 17 名 V 区患者（53 位数）和 14 名修复 II 区屈肌腱损伤的患者（25 位数）。所有患者均接受改良 Kleinert 方案治疗，并随访中位 60 个月。通过美国手外科学会的总主动运动评分系统评估解剖学的改善。采用手臂、肩部和手部快速残疾（Quick DASH）问卷和握力值来评估功能改善情况。结果：两组在年龄（P = 0.147）、性别（P = 0.889）、修复类型（P = 0.453）和随访时间（P = 0.499）方面相似。根据总主动运动评分系统，52% 的 II 区手指和 83% 的 V 区屈肌腱损伤手指获得良好到优秀的结果（正常总主动运动值的 75%-100%）（P = 0.004）。与未受伤的手相比，II 区和 V 区损伤的握力恢复率分别为 71% 和 53%（P = 0.112）。两组Quick DASH指数评分无差异（P=0.721）。患者的握力百分比（r = -0.435；P = 0.014）和总主动运动恢复结果（r = -0.541；P = 0.002）与 Quick DASH 评分呈中度相关。结论：与 II 区损伤相比，V 区损伤患者的早期被动活动获得良好至优秀结果的比例更高。然而，这并不意味着握力和残疾的恢复。这项研究表明，虽然损伤程度是解剖学改善的重要因素，但它可能不是功能改善的预测因素。
Objective: The aim of this study was to compare anatomic and functional improvements in zone II and zone V flexor tendon injuries and to determine the effect of injury level on disability.Design: Seventeen patients (53 digits) with zone V and 14 patients (25 digits) with repaired zone II flexor tendon injuries were enrolled in this study. All patients were treated with Modified Kleinert protocol and followed up for a median of 60 mos. The anatomic improvement was assessed by total active motion scoring system of the American Society for Surgery of the Hand. Quick Disability of the Arm, Shoulder, and Hand (Quick DASH) questionnaire and the grip strength value were used for the evaluation of functional improvement.Results: Two groups were similar with respect to age (P = 0.147), sex (P = 0.889), type of repair (P = 0.453), and follow-up period (P = 0.499). According to total active motion scoring system, good to excellent results (75%-100% of the normal total active motion value) were achieved in 52% of the digits with zone II and 83% of digits with zone V flexor tendon injuries (P = 0.004). The recovery in the grip strength, in comparison with the uninjured hand, has been found to be 71% and 53% in zone II and zone V injuries, respectively (P = 0.112). There was no difference between Quick DASH index scores of two groups (P = 0.721). The grip strength percentage (r = -0.435; P = 0.014) and total active motion recovery results (r = -0.541; P = 0.002) of the patients were moderately correlated with Quick DASH scores.Conclusions: Early passive mobilization in patients with zone V injuries resulted in higher percentage of good to excellent results when compared with zone II injuries. However, this does not translate into recovery in grip strength and disability. This study suggests that although the level of the injury is an important factor for the anatomic improvement, it may not be the predictor of functional improvement.