運用系列式槽狀副木矯治近端指間關節彎曲攣縮問題

The Application of Serial Gutter Splint for PIP Joint Flexion Contracture Problem

連淑惠(Shwu-Huei Lien) ； 馬海霞(Hae-Shya Ma)

《臺灣職能治療研究與實務雜誌》 2卷2期 (2006/12) Pp. 107-113

https://doi.org/10.6534/jtotrp.2006.2(2).107

摘要

近端指間關節(PIP joint)常因外傷或長期不動而造成軟組織纖維化，進而引發關節彎曲攣縮(flexion contracture)。針對這一問題，臨床上常以副木輔助治療，曾有學者建議運用三點加壓設計的槽狀掌側凸出之手指伸展副木(belly gutter)，其缺點是如果施加太大壓力，容易在關節背側組織造成壓瘡；因此我們認為，系列式槽狀副木(serial gutter splint)可以避免此類問題的發生，此一副木雖然也是運用壓力治療的原理，使纖維化的軟組織重新恢復彈性，但不會有壓瘡形成的問題，且製作容易又省時。在使用系列式槽狀副木時需定期檢查，視情況加以調整，以達最佳矯治效果，同時建議以自黏性彈性繃帶(COBAN)取代用粘扣帶固定的方法，除了提高矯治效果，患者穿戴容易而且較為舒服，可以提高配合穿戴的意願，因此提高治療的效果。

關鍵字

近端指間關節 ； 彎曲攣縮 ； 系列式槽狀副木

並列摘要

PIP joint flexion contracture is a common clinical problem that is caused by trauma or long-term immobilization which resulting in soft tissue fibrosis. Splints were used to reinforce the therapeutic effect to resolve this problem. However, clinicians often apply too much pressure over the dorsum of PIP joints, which result in pressure sore when using belly gutter. The use of serial gutter splints prevent from the disadvantage of belly gutter. Fabrication of a serial gutter splint is easy and time saving. We recommend that it is necessary to routinely check and re-adjust the serial gutter splints. Besides, the serial gutter splints should be fixed by COBAN instead of velcro loop. Easy to apply and less suffering can facilitate patients compliance, thus promote curative effects.

並列關鍵字

PIP Joint ； Flexion Contracture ； Serial Gutter Splint