屈指肌腱修復：術後治療與病例報告

Flexor Tendon Repair in Zone II: A Basic Postoperative Procedure and Case Report

吳鑫漢(Shin-Han Wu)

《職能治療學會雜誌》 3卷 (1985/09) Pp. 15-20

https://doi.org/10.6594/JTOTA.1985.03.03

摘要

縫合處斷裂與肌腱黏連是屈指肌腱修復後的兩大問題。近年來，控制式活動副木已成為屈指肌腱修復後避免斷裂和黏連的專業方法。原則上，修復手術後可立即穿戴此種副木；頭三周內傷指不可做主動性屈曲和被動性拉張運動，應小心做主動性伸指運動；第五周起可做輕度主動性屈指運動；六周過後才可做被動性拉張，副木同時可以不戴。六周以後設若黏連發生，副木、揉揑、和拉張等被動方式以及傷患的積極性合作，可以改善黏連的問題。本文內容除了陳述屈指肌腱修復後的治療步驟和要點，並報告二個與黏連問題有關的病例和討論。

並列摘要

The problems following digital flexor tendon repair are mainly due to the adhesion formation and rupture of the tendon repair. Reports of the results in preventing adhesion and rupture have demonstrated the advantage of controlled mobilization splint used following flexor tendon repair in no-man's-land.
The application of the splint and controlled mobilization is begun immediately after surgery. No active flexion and no passive extension stretch are allowed within the first three weeks postoperatively, but active extension against rubber band traction is encouraged. Gentle active flexion without resistance is started in the fourth week. Passive extension stretch is performed forty-two days after operation.
If contracture resulted from adhesion formation is present, it will be released with methods such as splinting, kneading, and stretch, and good cooperation of the patient.
A basic postoperative procedure for flexor tendon repair and two case reports concerning the effect of nonsurgical management on adhesion of tendon repair are presented in this paper.

並列關鍵字

flexor tendon nepair ； hand therapy