ZoneII屈筋腱断裂修復後の後療法の特徴に関する一考察 : 3週間固定法とKleinert変法の経時的関節可動域の比較

ZoneII屈筋腱断裂後の後療法について,3週間固定法とKleinert変法における獲得可動域の推移について,34例35指(3週間固定法:20例20指,Kleinert変法:14例15指)を対象とし調査した.最終成績を群別に分けて検討した結果,3週間固定法,Kleinert変法ともに,近位指節間関節,遠位指節間関節の伸展方向への改善が良好な成績へと結びつく要因であった.また,Kleinert変法の成績良好例では遠位指節間関節での伸展可動域回復が著明に認められ,深指屈筋腱の単独滑走回復の重要性が示唆された. 以上から,早期運動療法の利点を3週間固定法に活かし良好な成績を得るには,屈曲可動域を維持しながら自動伸展あるいは他動伸展運動での回復を図り,可及的早期に深指屈筋腱の独立した滑走を促進させる事が推奨された.

This study compared progress of range of motion(ROM)outcomes between 3 weeks of immobilization(20 cases, 20 fingers)and modified Kleinert method(14 cases, 15 fingers)as postoperative treatments following surgical repair of flexor tendon rupture in ZoneⅡ. Both postoperative treatments were divided into outcomes by Strickland's evaluation method. As a result, both treatment methods showed an improvement to the extension of the proximal interphalangeal joint(PIP joint)and the distal interphalangeal joint(DIP joint). In addition, good recovery of the DIP joint was clearly observed in the modified Kleinert method, and the importance of single excursion of flexor digitorum profundus(FDP)was indicated. As above, we recommend that therapists promote active or passive extension exercise, and promote single excursion of FDP, if using the 3 weeks immobilization method, as soon as possible.