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European Journal of Physical and Rehabilitation Medicine 2014 February;50(1):49-57

Copyright © 2014 EDIZIONI MINERVA MEDICA

lingua: Inglese

A modified spica-splint in postoperative early-motion management of skier’s thumb lesion: a randomized clinical trial

Rocchi L. 1, 2, Merolli A. 1, Morini A. 1, Monteleone G. 3, Foti C. 2

1 Orthopedics and Hand Surgery The Catholic University School of Medicine, Rome, Italy; 2 Doctorate in Advanced Technology in Physical and Rehabilitation Medicine and Sport Tor Vergata University, Rome, Italy; 3 Department of Biomedicine and Prevention Medicine, School of Sport and Exercise Sciences Faculty of Medicine and Surgery Tor Vergata University, Rome, Italy


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Background: Rupture of ulnar collateral ligament of the thumb (UCL) represents a frequent injury of the hand. Surgical repair is considered the gold standard but postoperative immobilization causes partial stiffness in a percentage of cases.
Aim: The aim of this paper was to assess the effectiveness of a postoperative functional hand-based splint for the thumb which allows immediate postoperative motion.
Design: Randomized prospective clinical trial.
Setting: The study was carried out at the Orthopedics and Hand Surgery Unit of The Catholic University School of Medicine, Rome, Italy.
Population: Thirty consecutive patients, with a diagnosis of acute complete tear of the UCL, were selected to be treated surgically (predominantly men, mean age 39). Cases presenting associated injuries were not included.
Methods: Patients were randomized postoperatively into 2 groups of 15 (one using the new splint and the other using a standard spica splint). After four weeks of splinting, clinical outpatient evaluations were carried on (at one, two, six, twelve months) on both groups to evaluate: joint stability; pain; pinch strength; range of motion; time lost from work; sessions of physiotherapy.
Results: Immediate postoperative motion of the operated joint produced faster and better functional results. No cases of recurrence were recorded.
Conclusions: Surgical repair, combined with active metacarpophalangeal motion allowed by the new functional splint, was effective, safe and well tolerated.
Clinical rehabilitation impact: Enhancing the patients’ function and reducing the time of functional recovery, the reported treatment presents potential advantages in the management of this frequent acute hand injury.

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