| Objectives1.to understand the function recovery process and characteristics of the pat ients with hand tendon injuries in the first 6 months after operation2.to understand the patient’s founction problems and its influence factors3.to find out the the problems of patients’ rehabilitation process outside the hospital4.to track the patients’ outcome and the satisfaction of recovery after trau ma Method99 patients with flexor tendon injuries from November 2014 to May 2015 in our hospital were slected as the research object by convenience sampling method. On the basis of literature review, data were collected by means of que-stionnaires answered by the patients before discharge and 1 month, 3 months and 6 months after operation with the approach of telephone follow-up. The r-epeated measures analysis of variance was made to examine subsequent hand function changes over time.Analysis the the existence of function problems and the impacts on patients in various stages.Examine the outcomes and satisfactio-n of life after trauma, and give the corresponding suggestions.Results1.The hand function score of the patients before discharge was 43.83±15.47.Besides,there were also founctional problems like wringing out a towel(n=18),toileting(n=15),feeding(n=10),brushing teeth(n=8),fastening belt(n=5),doing up buttons(n=2),combing hair(n=2).1 month after operation,the hand founction score was 35.71±14.66.The problems of activities were almost the same as before,but some complications such as edema(n=12),stiffnes(n=10),seffection(n=5),amyot-rophy(n=2) and so on appeared during this time. 3 months after discharge,thehand founction score was 15.68±11.77.At this time,patients’ ability of activities of daily living was significantly increased(p<0.05),but there were still many complications:lack in strength(n=12),rebond hypertrophy(n=7),hyperesthesia(n=3).6 months after operation,the hand founction score was 11.54±9.29.In this stage,the psychology of the patients tended to remain unchanged(1.64±0.76, p>0.05),and ranked 8th.During this time, some founctional problems left behind such as lack in strength(n=12),hyperesthe-sia(n=2),stiffness(n=4),amyotrophy(n=3),using chopsticks(n=4),doing up buttons(n=2),using key-board(n=1) and so on.2.In a longitudinal comparison with time as the independent variable, The D-value of each two adjacent time points were-8.90,-19.76 and-4.13,and have statistical significance(p<0.05). In the horizontal comparison with demogra-phic factors and the traumatic factors as the independent variables,There was no statistical difference in hand function in patients with different age and different wound sites.But hand function was significantly different in patients with different gender,education level,occupation,nature of trauma and trauma severity.3. The number of patients using two or more methods to help recovery outside hospital in each stage was 15(19.5%),16(24.6%) and 12(33.3%).Patients who do exercise very frequently in each stage was 18(19.4%),7(8.1%) and 2(2.4%),often was 42(45.2%),23(26.7%) and 15(18.1%),sometimes was 17(18.3%),35(40.7%) and 19(22.9%),never was 16(17.2%),21(24.4%) and 47(56.6%).4.The rehabilitation satisfaction score in each stage was 73.12±13.04,76.79±13.64 and 78.94±12.94,and has significantly increased.Patients of different ages have different satisfaction level and the male is higher than the female.The rehabilitation satisfaction level was also different in the patients with differ ent trauma severity.5.There were 77 patients have returned to work during the 6 months-follow-up,9 patients have dropped out,2 patients received second surgery and 10 pat-ients remained out of work.The mean time patients return to work was 52.44±39.91 days,ranged from 5 to 180.Among who have returned to work,66(66.7%) patients did the job they used to do,11(11.1%) changed the job position,13(13.1%) patients said the income decreased and 15(15.2%)said that all the ch-anges above were related to hand injuries.Conclusions1.The rehabilitation of hand founction after tendon injury is a long-term pr-ocess.The function of hand has been in a significant upward trend in the first6 months and hand founction restores fastest between 1 to 3 months after operation.The results can let the patients and medical staff have further understanding of tendon healing process,in order to carry out the effective rehabilitation guidance and rehabilitation exercise in the best period to increase the recovery opportunity.2.The founctional problems patients experienced in diffierent stages have b-oth similarities and differences.Patients have difficulties in cooking,outdoor labor(trim-ming,weeding,cleaning),physical labor(using a hammer),sports(plying frisb-ee,badminton) and the work they used to do though the whole process.Within1 month after operation,ADLs are the main problems and complications associa-ted with restriction are much likely to occur.From 1 month to 3 months,patien-ts’ ability of activities increased.The needs of strength and appearance increase-d,the main problems are occupational activity disabilities and lack of rehabilita-tion knowledge.From 3 months to 6 months, the trauma related psychological problems are very prominent and a lot of founctional problems remain at the end of the observation.So we should implement targeted interventions according to the outstanding problems of different periods to prevent the problems from occurring and improve the effect of rehabilitation at the same time.3.Gender, educational level, occupation, trauma and the severity of trauma were the influencing factors of hand function in patients with hand tendon inju-ry, but the hand function was not correlated with age and trauma site.4.Patients are short of rehabilitation knowledge and do exercise without regularity,continuity and diverse rehabilitation approach.5.post-trauma rehabilitation satisfaction is improving continuously within 6months,but still at a low level.Due to the dysfunction caused by trauma,the job position,salary and so on are affected to a great extent. Some patients still out of work at the end of the observation. |
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