肘関節拘縮に対する動的スプリントの製作方法

Fabrication method of dynamic splint for elbow contracture

要旨：肘関節は関節拘縮が多く，特に伸展可動域の獲得に難渋する．そこで熱可塑性スプリント材とコードハンガー，フック付セラバンドを用いた動的スプリントを作製し，良好な関節可動域が得られた．本スプリントは安価で作製できて軽量であり，患者の状態に合わせて容易に修正が可能である．一方で牽引力の設定や負荷調節が難しいという問題があり，今後は適正な牽引方向と矯正力の検討を要する．

　Since many elbow joint contractures result in postoperative complications and trauma, improvement of ROM is difficult. Splint therapy includes utilizing a turnbuckle or splint flexion cuff, but contracture remains in many cases. We have created a dynamic splint to shrink elbow joint contracture, using low-load duration expansion with a focus on home training beginning early in the postoperative period. A 30-year-old man presenting with supracondylar fracture of the humerus underwent extension training with the dynamic splint beginning four weeks after surgery. By combining splint therapy at home with weekly outpatient sessions, a 67 degree improvement in flexion and extension arc of the elbow joint was obtained. Extension ROM limit reached 10 degrees or less. Advantages of the dynamic splint include low manufacturing cost, compactness and light weight, and ease of modification. Disadvantages include difficulty in configuration adjustment and load tow direction. Proper tow force and direction, as well as optimizing wearing time of the splint are should be considered in the future.