| ObjectiveTo investigate the clinical effect of the multifunctional dynamic orthosis in the treatment of the Lateral Ligamentous Contracture of Metacarpophalangeal JointMethodsTotal21cases of the Lateral Ligamentous Contracture of Metacarpophalangeal Joint were collected in a period of June2010to January2012. All of them had been worn Multifunctional dynamic Orthosis for3months to observe the TAM (total active movement) digital quantity of the Metacarpophalangeal Joint, which were compared with the result of20cases treating without Multifunctional dynamic Orthosis, and then statistical analysis was conducted. In this study,we proceeded functional evaluation on the basis of the total active range of hand-Determination Act (total active movement, TAM), and the main outcome measures included the active range of Metacarpophalangeal joint, the ratio of recovery with favorable function and the secondary surgery ratio.ResultsThe orthosis in the treatment of the lateral ligamentous contracture of metacarpophalangeal joint, comparing with the control group without orthosis, could effectively promote the functional recovery of metacarpophalangeal joint and reduce the chance of secondary surgery. All patients had been treated for three months, and some results as follows:①The mean TAM of patients who had been treated by Multifunctional dynamic Orthosis for3months, compared with the mean TAM before the treatment, Managing by t-test,(P<0.05), there are significant difference. The former was obviously better than the latter.. And The mean TAM of patients who had been treated by Multifunctional dynamic Orthosis for3months, compared with the mean TAM of patients who had been treated in the control group, but no orthosis, Managing by t-test,(P<0.05), there are significant difference, the mean TAM of experiment group was obviously better than the control group, indicating that the Multifunctional dynamic Orthosis is effective in treating of the lateral ligamentous contracture of metacarpophalangeal joint.③The total ratio of recovery with favorable function in experiment group was91.9%, and the total ratio of recovery with favorable function in control group was57.4%. These datas showed that the treatment efficiency of experiment group was better than the one of control groups, which proved that the Multifunctional dynamic Orthosis was effective in treating of the lateral ligamentous contracture of metacarpophalangeal joint.③To compare the functional recovery of different fingers in experiment group with the one in control group:to compare between groups, aim at the metacarpophalangeal joint of index fingers, the ratio of recovery with favorable function in experiment group was87.5%, which was better than53.9%(P<0.05) in control groups. Aim at the metacarpophalangeal joint of middle fingers, the ratio of recovery with favorable function in experiment group was94.4%, which was better than55.0%(P<0.05) in control groups. Aim at the metacarpophalangeal joint of ring fingers, the ratio of recovery with favorable function in experiment group was93.3%, which was better than58.8%(P<0.05) in control groups. Aim at the metacarpophalangeal joint of little fingers, the ratio of recovery with favorable function in experiment group was92.3%, which was better than63.6%(P<0.05) in control groups. All these datas showed that the treatment efficiency of experiment group was better than the one of control groups, no matter which type of fingers. To compare within groups, no matter the experimental group or the control group, there were significantiy different, which means that the difference of fingers don’t affect the treatment effect.④Patients, at the same ages, were compared to understand the functional recovery between the experiment group and the control group:To compare between groups, aim at patients who were at the age of18～25, the ratio of recovery with favorable function in experiment group was91.0%, which was better than60.0%(P<0.05) in control groups. Aim at patients who were at the age of26^35, the ratio of recovery with favorable function in experiment group was95.2%, which was better than56.3%(P<0.05) in control groups. Aim at patients who were at the age of3645, the ratio of recovery with favorable function in experiment group was92.7%, which was better than54.5%(P<0.05) in control groups. Aim at patients who were at the age of46～60, the ratio of recovery with favorable function in experiment group was88.9%, which was better than57.9%(P<0.05) in control groups. Datas above showed that the treatment efficiency of experiment group was better than the one of control groups, no matter what age patients were. To compare within groups, no matter the experimental group or the control group, there were significantiy different, which means that ages don’t affect the treatment effect.⑤Patients, at the same time of injury, were also compared to understand the functional recovery between the experiment group and the control group: To compare between groups,aim at patients whose time of injury were in30to 60days, the ratio of recovery with favorable function in experiment group was100.0%, which was better than64.5%(P<0.05) in control groups. Aim at patients whose time of injury were in61to90days, the ratio of recovery with favorable function in experiment group was89.7%, which was better than52.2%(P<0.05) in control groups. Aim at patients whose time of injury were More than90days, the ratio of recovery with favorable function in experiment group was66.7%, which was better than42.9%(P<0.05) in control groups. These datas above showed that the treatment efficiency of experiment group was better than the one of control groups,no matter what time of injury patients were. To compare within groups, no matter the experimental group or the control group, the ratio of recovery with favorable function in30to60days was better than the one in61to90days and more than90days, the ratio of recovery with favorable function in61to90days was better than the one more than90days. Results above shows that the different time of injury can affect treatment effect, and the shorter time of injure is, the better treatment effect is.⑥No one needed to do secondary surgery in the experimental group, and2cases,7fingers altogether, needed to do secondary surgery in the control group, which was10%of total patients, and11.5%of total fingers in the control group. Moreover, there was no untoward effect report in the experimental group throughout the treatment process.ConclusionThe Lateral Ligamentous Contracture of Metacarpophalangeal Joint is a common disease in hand surgery, and the Multifunctional dynamic Orthosis is effective in treating of the lateral ligamentous contracture of metacarpophalangeal joint. The total ratio of recovery with favorable function in experiment group was up to91.9%,. Furthermore, regardless of the different fingers, ages and time of injury, the treatment efficiency of experiment group was superior to the one of control groups. Besides, the Multifunctional dynamic Orthosis can effectively promote the function recovery of Metacarpophalangeal Joint, reduce the risk of the secondary surgery, recover the function of hand. Meanwhile, there was no untoward effect report in the treatment process. In a word, it is security and effective that We treat patients who suffer from the lateral ligamentous contracture of metacarpophalangeal joint with multifunctional dynamic orthosis. So,the multifunctional dynamic orthosis is worthy of clinic application. |
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