手外伤术后关节活动能力与功能的相关性

摘要 目的：研究手外伤术后患者手部关节活动能力与手功能恢复的相关性。 方法：对2012年11月—2013年3月我院32例手外伤术后康复患者，评估拇指对指功能评分、前臂旋转角度、腕关节活动度和手指关节总主动活动度（TAM）。采用Jebsen手功能测试量表评定手功能，进行直线相关分析和多元线性逐步回归分析。 结果：拇指对指功能评分与写字、叠棋子和捡小物时间呈负相关性。拇指TAM与翻纸牌和拿大的重罐子时间呈负相关性。前臂旋前角度与拿大的轻罐子时间呈负相关性。 结论：拇指对指功能评分、拇指TAM是影响测试的关键因素。术后康复应以恢复对指功能和拇指活动度为重点。术后固定时，应尽量开放无损伤部位，维持拇指活动度和对指功能。

A study on correlation between ability of motion of joints and function in post-hand injury patients after surgery

Abstract Objective: To investigate the correlation between ability of motion of hand joints and hand function recovery in post-hand injury patients after surgery. Method: Thirty-two hand injury patients after surgery were evaluated with Jebsen hand function test, score of thumb opposition function and range of motion of forearm, wrist and fingers. Bivariate linear correlations and multivariate linear regression were analysed. Result: The thumb opposition function was the main negative influence factor on writing, stacking checkers and picking up small common objects. Thumb TAM was the main negative influence factor for time of turning over cards and picking up large heavy cans. Forearm pronation was the main negative influence factor on picking up large light cans. Conclusion: The main influence factors on hand function were thumb opposition function and thumb TAM. So rehabilitation after surgery has to be focused on the thumb movement and opposition function. Positions without injury should be opened in order to sustain thumb movement and opposition function after surgery. Early rehabilitation can alleviate the limits of joint motion.