Kev soj ntsuam ntawm kev siv nyhuv ntawm cov kev sib tsoo ntawm kev kho cov kev raug mob hauv txhais tes tom qab phais tas
Lub Hom Phiaj: Txhawm rau tshawb cov qauv kev kho mob thiab kev ua tau zoo ntawm kev siv cov kev siv ua haujlwm sib xyaw ua ke tom qab kev kho mob txuas ntxiv hauv tes. Txoj kev: 26 tus neeg mob uas muaj 65 ntiv tes txuas ntxiv raug mob (III-VICH Pawg tswj hwm (28 tus ntiv tes thiab 69 ntiv tes) tsis tau txais kev kho kom rov kho dua tshiab ntxiv rau kev kho mob hauv tsev kho mob thaum ntxov. Raws li kev kho kom rov kho tau ntxov, kev faib ua feem ntawm cov neeg mob ua haujlwm tau zoo tshaj rau pawg tswj hwm, raws li kev ntsuas los ntawm TAM Txujci. Xaus: Qhov kev cuam tshuam ntawm kev sib tsoo dynamic kev ua kom tau kev kho mob muab kev nyab xeeb rau kev nyab xeeb rau kev ua haujlwm ntxov. Passive txav nyob rau hauv kev tswj kav txuas tau tau maj mam hloov cov txheej txheem ntawm ua tiav braking. Tom qab kev kho ntawm extensor leeg raug mob hauv tes, kev tawm dag zog thaum ntxov thiab ua tau zoo tuaj yeem tiv thaiv kev sib xyaw ua ke, zam kev phais theem nrab.
Lossis: extensor leeg raug mob; Lub Hwjchim Pab Txhawb Nqa; Kev tsim kho txuas ntxiv ntawm kev tawm dag zog thaum ntxov thiab kev phais mob tau ua tiav kev kho cov kev kho kom paub ntau dua. Txawm li cas los xij, vim lub sijhawm ntev immobilization lossis kev cob qhia tsis txaus tom qab raug mob, sib txawv ntawm cov leeg txoj haujlwm yuav tshwm sim. Hauv kev kho kom rov zoo ntawm txhais tes extensor leeg kho kev kho mob ntawm lub tsev kho mob uas tus kheej tsim kev kho kom zoo nkauj ua los ntawm cov ntawv tiag tiag uas yog siv; Tso cai rau cov neeg mob kom nquag ua lawv cov ntiv tes thaum ntxov nyob rau hauv kev tswj hwm ntawm cov hlau xaim, thiab siv nws cov txiaj ntsig tau ua tiav cov txiaj ntsig tau zoo.
1. Cov ntaub ntawv thiab cov hau kev
1.1 General Information: From August 2004 to January 2005, the author's hospital treated 26 cases (65 fingers) of hand extensor tendon (zones III-VII) injuries who underwent early application of dynamic braces for functional exercise under protection after primary tendon repair surgery (rehabilitation group). The fabrication of braces for extensor tendon injuries (I-II) varies; There are few cases of patients with finger bone fractures and combined flexor tendon injuries using this brace, and this article did not evaluate it. Another 28 cases (69 fingers) without formal rehabilitation treatment after previous treatment were selected as the control group. The general situation of the two groups is shown in Table 1. There were no statistically significant differences in gender, age, injury type, injury finger type, and injury site between the two groups (all P>0.05).
1.2 Kev Rov Kho Dua Tshiab: Txhua qhov kev raug mob raug kho kom raug kho los ntawm cov qauv kws tshaj lij ntawm cov qauv kev coj ua [2]. Qhov kev phais mob yuav tsum ua tiav hauv 12 teev tom qab raug mob. Cov pab pawg kho kom tau txais kev pab coj tau kev coj ua uas coj tau kev coj ua, kev npaj kho mob ib qib zuj zus, thiab kev phais mob.
1.2.1 cov phaj thermoplastic phaj (tsim los ntawm Guangzhou Kolairedi Medical Equipment Co., Ltd. Txuas ntxiv lub dab teg sib koom ntawm 2 {0 degree {5}} degree, txuas tus dab teg, txuas ntxiv tus dab teg ncaj ntawm 0 degree); Nws ntev ntev los ntawm nruab nrab ntawm forearm mus rau Metacarpophalangeal sib koom sab sab nraub qaum. Ib txhij ua rau cov hlau xaim loj ywj qub rau ncab cov ntiv tes: xaiv cov ntsiab lus hauv qab dab teg ntawm lub dab teg thiab metacarpal pob txha ntawm cov pob txha thiab metacarpal. Mus nrog kev raug mob
Cov lus 1 sib piv ntawm kev ncab kev raug mob ntawm ob pab neeg (ntiv tes) 23514 ~ 4722691621158158155811211 Tus ntiv tes sib haum rau cov xov hlau tsau nrog cov xaus. Qhov ntev ntawm tus hlau xaim feem ntau yog nkhaus rau qhov kawg ntawm cov ntiv tes, thiab qhov kawg ntawm cov ntiv tes xoo hluav taws xob, uas yog ntsug muab tso rau ntawm cov ntiv tes ntawm cov ntiv tes raug mob. Ruaj ntseg cov kev txhawb nqa nrog Velcro.
1.2.2 Kev kho kom rov zoo li cas los kho cov pab pawg (1) Cov pab pawg kho mob pib siv cov brace tom qab 48 teev ntawm qhov txhab hemostasis thiab kev ruaj khov. Raws li cov kev taw qhia ntawm tus kws kho mob rov qab, nquag siv tus ntiv tes raug mob los ntawm kev vam khom tus ntiv tes, thiab ua kom {{5} {zaus ib teev. Nce lossis txo tus naj npawb ntawm cov kev ua ub no thiab qib kev hloov pauv raws li cov tshuaj tiv thaiv; Hnav kev kho kom rov kho tau ib hnub. (2) Peb lub lis piam (22 hnub) tom qab phais tas, feem ntau yog tshem tawm thiab hloov nrog lub dab teg txuas ntxiv), (yog tias muaj lub ntsej muag txuas ntxiv, lub dab teg txuas ntxiv yog 0 degree); Nquag flexion thiab txuas cov ntiv tes; Txuas ntxiv hnav nws ib hnub. (3) Tom qab 4-6 lub lis piam posteroeratively, tshem tawm lub dab teg txuas ntxiv brace nruab hnub thiab hnav nws thaum tsaus ntuj; Kev maj mam tiv taus cov kev lom zem ntiv tes. (4) Tom qab 7 lub lis piam (50 hnub) Posteratively, tag nrho cov braces tau raug tshem tawm thiab ua tiav kev tawm dag zog tiv thaiv tau pib txhim kho cov leeg kom muaj zog. Thiab tau txais cov haujlwm kho hauv tsev, kev coj muaj zog khawm, nqa, pinching kev cob qhia, thiab ntiv tes dexterity thiab kev cob qhia kev kawm. Tom qab 12 lub lis piam, rov pib ua haujlwm. Pab pawg tswj: tom qab extensor leeg kho kev phais, kho cov ntaub qhwv tau siv los ua cov tes plhaw, txhim kho lub dab teg thiab ntiv tes sib koom ua ke hauv cov pob qij txha deliflexion. Cov ntaub qhwv plaster tuaj yeem tshem tawm tom qab {16}} lub lis piam ua ntej pib ua si. Tsuas yog kev kho mob kho mob ib txwm, tsis muaj programmed kev kho mob kho kom zoo nkauj yog ua, thiab lub qhov txhab raug tshem tawm tom qab kho. Txhua tus neeg mob tau ua raws thiab pom rau {17}} lub hlis. Kev ua haujlwm rov qab tau ntsuas siv txoj kev tam sim no los txiav txim siab ua cov qauv ua tau zoo; Thiab tus naj npawb ntawm cov rooj plaub uas xa rov qab mus rau lawv txoj haujlwm qub peb lub hlis tom qab phais tas; Tom qab tsom xam cov ntsiab lus, qhov sib txawv ntawm ob yog cov lus tseem ceeb nrog tus nqi ntawm 7.81 (p<0.05), as shown in Table 2. Table 2 Comparison of follow-up recovery between two groups of patients n (%) Number of cases in each group Excellent, medium poor, excellent rate (%) Recovery of original work P-value Rehabilitation group 2616 (61.5) 8 (30.8) 2 (7.7) 0 (0) 92.323 (88.5)
<0.05 Control group 288 (28.6) 10 (35.7) 5 (17.9) 5 (17.9) 64.315 (53.8) 3 Discussion
3.1 Kev raug mob no muaj kev tiv thaiv kev ua haujlwm hnyav. Cov extensor cov qauv qauv yog tiaj, nyias, dav, thiab ntau dua siab rau kev tawg. Txoj kev ntawm sab nraub qaum ntawm tes yog ntiav, nrog tus nqi ntawm kev raug mob, thiab muaj kev sib tw nrog cov pob txha. Hloov lossis adhesions nyob rau hauv qhov ntev ntawm extensor tendon tuaj yeem cuam tshuam rau kev sib kis mob, ua rau cov nyom rau tus neeg sib tw. Yav dhau los, palmar plaster cov ntaub ntawv pov tseg tau siv txuas ntxiv tom qab extensor leeg kho lub dab teg los kho lub dab teg thiab ntiv tes sib koom ua ke hauv dorsiflexion txoj hauj lwm. Cov ntaub pua plag plaster tuaj yeem tshem tawm tom qab 4-6 lub lis piam ua ntej pib ua si. Vim kev siv tus ntsuas braking tom qab phais tas, nws yog qhov yooj yim los ua kom sib txawv ntawm cov nplaum sib txuas, thiab txawm tias kev cog lus, tawm tes tsis sib xws thiab cuam tshuam rau kev ua haujlwm thiab lub neej. Yog tias kev kho kom rov kho kho tsis tau siv thaum ntxov, tus nqi xiam oob khab yog qhov siab. Tom qab soj ntsuam, tus kws sau pom tias tus kheej tsim hluav taws xob kev sib tw ua los ntawm extensensor tev (aones III-VII). Kev siv lub zog thaum ntxov nrog kev tawm dag zog ua ke nrog kev tawm dag zog zoo thiab sib koom ua ke los ntawm kev tswj cov leeg sib koom ua ke thiab ua kom muaj zog. Raws li qhia hauv Table 2, qhov zoo tshaj plaws thiab zoo tshaj ntawm cov pab pawg kho kom rov zoo siab yog siab dua li ntawm pawg tswj. Kev Kho Kom Zoo Kawm Thaum Ntxov tuaj yeem txhim kho cov qhab nia tam sim no ntawm cov neeg mob thiab pab txhawb kev rov ua haujlwm ntawm lawv tes ua haujlwm.
3.2 Tam sim no tau pom txoj kev zoo tshaj plaws rau kev tiv thaiv cov khoom nplaum no tseem rov kho dua tshiab los ntawm kev tawm dag zog thaum ntxov. Kev Kho Kom Rov Nrhiav Kom Tau Kev Kho Mob yog lub sijhawm tseem ceeb uas txiav txim siab ua tiav lossis tsis ua haujlwm ntawm kev ua haujlwm. Cov Postoperative kev ua haujlwm tau rov qab yog nyob ntawm kev ua haujlwm zoo thiab ua haujlwm tau raws sijhawm. Tsis pub dhau 24-48}}}}}}}}}}}} kev phais, lub ntsiab tseem ceeb yuav tsum nyob rau ntawm immobilization. Tom qab 48 teev, kev hnav khaub ncaws ntau dhau yuav tsum tau muab tshem tawm thiab ua kom rov kho dua tshiab thiab tau npaj rov ua kom rov zoo. Kev siv cov hwj chim txhawb nqa muab kev nyab xeeb zoo rau kev ua haujlwm ntxov. Lub hwj chim txhawb nqa ntawm txhais tes ua ke cov nquag thiab passive taw ntawm intercasalangeal pob qij txha los ntawm traction. Thaum ntxov txav tuaj yeem ua kom muaj kev nyob deb li qub thiab zawv zawg kev deb, txhawb kev puas zoo thiab caws pliav. O o tshem tawm kev tawm dag zog sai sai, thiab thaum ntxov ua kom rov ua kom rov zoo nkauj thiab rov ua haujlwm theem nrab thiab muaj txiaj ntsig zoo ntawm 90%. Passive txav nyob rau hauv kev tswj kav txuas tau tau maj mam hloov cov txheej txheem ntawm ua tiav braking.
3.3 Txhawm rau kom ua tiav txoj kev rov zoo dua ntawm tes ua haujlwm tom qab kev raug mob, thiab kev kawm kom rov kho dua tshiab yog qhov txuas tsis tau yog qhov tseem ceeb thiab tseem ceeb link [3]. Kev kho mob hlwb yuav tsum tau ua ke rau kev kho kom rov kho dua
Tag nrho cov txheej txheem. Piav qhov tseem ceeb ntawm kev tawm dag zog rau kev tawm dag zog rau cov neeg mob, thiab lwm tus ua tiav ib nrab ntawm cov postoperative ua haujlwm rov ua haujlwm. Kev soj ntsuam txhua hnub thiab cov kev taw qhia tau muab rau cov neeg mob, saib xyuas qhov kev vam meej ntawm kev kov yeej cov kab mob thiab ua rau muaj kev kho mob zoo tshaj plaws.
Tus yuam sij rau thaum ntxov txhais tes tswj tau cov kev ua si nyob hauv kev tsim cov tes ua haujlwm txhawb nqa. Tsawg qhov kub kub thermoplastic daim hlau ua cov khoom uas txhawb nqa tsis yog tsuas yog tsim thiab lub ntsej muag zoo nkauj thiab meej meej. Lawv tuaj yeem rov ua tiav cov txheej txheem thiab hloov kho lub sijhawm twg los tau, yog yooj yim rau kev siv, uas yog ntau dua li kev txhawb nqa lossis resin qhwv. Nws yog qhov cuab yeej tsim nyog rau kev tawm dag zog ntxov tom qab extensor leeg phais.
