Clinical Observation On Prevention Of Adhesion After Flexor Tendon Rupture By Early Programmed Exercise

ObjectiveTo observe the clinical rehabilitation effect of early programmed function exercise on preventing tendon adhesion after flexor tendon repair.MethodsSelect 52 cases of flexor digitorum tendon repair,the group can be divided into 27cases(N=27,a total of 51 fingers)and 25 cases in control group(N=25,a total of 47 fingers).The two groups can use modified Kessler combined with continuous peritendinous suture to suture tendon.Two groups peformed routine rehabilitation therapy,Including the same angle of plaster external fixation,Teding Diancibo pu(TDP)irradiation(From the third day to the sixth day,twice a day,once 20 minutes).physical therapy,psychological counseling,rehabilitation therapy after 3 weeks of braking.Early Programmed Functional Exercise patients start to use early programmed functional exercise,After the plaster fixation,the wrist joint was flexed 30°,the flexion of metacarpophalangeal joint was flexed 70 degrees,and the distal and proximal interphalangeal joint is extended.The treatment of swelling,pain relief and antiinflammatory drugs is given priority to in the first two days.Drugs are changed on the third day after the operation,plastics plaster with low temperature is replaced,and the affected fingers are moved every day from the third to the sixth day,additional TDP irradiation.The seventh to the fourteenth days,increase activity,adjust the plaster angle,seventh to the fourteenth days after surgery,wrist flexion 20 degrees.The flexion of metacarpophalangeal joint was 50 degrees and the proximal and distal interphalangeal joint was extended.From 15 to 21 days after operation,wrist flexion was 10 degrees,metacarpophalangeal flexion was 40 degrees,and distal and proximal interphalangeal joint was extended.22-28 days after operation:wrist neutral position,metacarpophalangeal joint flexion 30 degrees,distal and proximal interphalangeal joint extension position.The plaster was removed on the 28th day after the operation and continued to perform functional exercises.The follow-up period was from 8 weeks after the operation.The brake-passive-active functional exercises were used after the operation.The physician conducted three passive flexion and extension exercises within one week after the operation.The physician assisted the standardized flexion and extension exercises on the 8th to 14th day,and the active flexion and extension exercises were started on the 28d to 56d(see the early programmed functional exercise schedule for specific programs).Both groups were observed for 8 weeks.Total Active Motion(TAM)was assessed at the end of 8 weeks after treatment.ResultsAll cases were followed up for 8 weeks.After 8 weeks of observation,the TAM of early programmed functional exercise patients' fingers was 89.68±12.02.The TAM%grade of fingers was excellent in 25 fingers,good in 19 fingers,middle in 6 fingers and poor in 2 fingers.In routine rehabilitation group,TAM%of fingers was 74.93±17.25,and TAM%of fingers was evaluated as excellent in 10 fingers,good in 19 fingers,middle in 13 fingers and poor in 5 fingers.The results showed that after treatment,the TAM%results of fingers in early programmed functional exercise group were better than those in routine rehabilitation group,and there was significant difference between the two groups(P<0.05).ConclusionThe effect of early programmed functional exercise on tendon adhesion after repair of flexor digitorum tendon is better than that of routine rehabilitation.And its curative effect is superrior to the clinical application of conventional rehabilitation treatment effect.