The Exploratory Development Of Dynamic Orthosis In The Treatment Of Retrograde Avulsion Injury In Palmaris Skin

Objective:To investigate the clinical effect of combinatorial dynamic orthosis in the treatment of retrograde avulsion injury of palmaris skin in hand.Method:Selected 20 cases of hand avulsion of patients with retrograde from March 2008 to May 2010, installed in the postoperative rehabilitation of hand function exercise for three months to observe the effects and with access to 20 cases with follow-up course of treatment without the use of dynamic orthosis conventional treatment of the palm brace retrograde avulsion of skin of patients as controls, were analyzed. In this study, the total active range of hand-Determination Act (total active movement, TAM) for functional evaluation to postoperative complication rate, reoperation rate as needed to improve the function of the main observed.Results:1,TAM assessment of hand function:Support a good rate of 94% of experi mental group, routine excellent and a good rate 52%(P<0.05); the effect of varying degrees of injury in comparison, the experimental group supporting high efficacy of the treatment of mild injury rate 100%, better than the conventional group 85.71%(P<0.05); support efficacy excellent with the treatment of moderate injuries was 97.8%better than conventional treatment group 42.5%(P<0.01); support the treatment of severe injury with 80%good better than the conventional therapy group 20%(P<0.01).2,Postoperative complications Statistics:contractures of the first web space treatment group the proportion of patients with normal or mild contracture of 90%, significantly better than the conventional treatment group,60%; support patients with the treatment group and 12 patients without postoperative complications (60%), scar contracture occurred in 7 cases (35%), tendon adhesion in 5 cases (25%), joint stiffness in 4 cases (20%); conventional treatment group were without complications in 2 cases (10%), scar contracture occurs 16 cases (80%), tendon adhesions in 11 cases (55%), joint stiffness in 12 patients (60%).3,Reoperation rate as needed to improve the function statistics: statistics between the two groups were statistically significant (P <0.05), supporting a treatment group of patients without second surgery in 12 patients (60%), take the tiger's mouth open major surgery (2 cases 10%), scar release in 5 patients (25%), tendon release operation in 3 cases (25%), joint loosening in 2 cases (10%); conventional treatment group patients without reoperation (6 cases 30%), tiger's mouth to open a large operation in 7 cases (35%), scar lysis in 12 cases (60%), tendon release was performed in 8 patients (40%), joint release was performed in 10 patients (50%).Conclusion:The hand skin avulsion injury after retrograde application of hand dynamic orthosis treatment, excellent recovery of hand function up to 94%efficiency, can reduce the scar contracture, tendon adhesion, joint stiffness, first web space contracture and other complications of occurrence, reoperation rate as needed to improve the function of the application process without adverse reaction. Combinatorial dynamic orthosisr used in the rehabilitation treatment of such diseases, safe and effective, worthy of clinical application.