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要旨:我々は,仕事中に右上肢を機械に挟まれ,右上肢Ⅲ度熱傷,示指から小指の中手骨レベルで切断に至った症例を担当した.母指は残存したものの重度の関節拘縮が生じ,対立の相手役となる示指から小指をすべて失ったため,物の把持が困難となった.これに対し,熱可塑性スプリント材で欠損指を再現し,将来的に作製する義手を見据えた練習用仮義手を作製し,作業療法を実施した.その結果,練習用仮義手装着下では,右上肢機能の改善,ADLでの積極的な使用,主観的満足度の向上を認めた.
A XX-year-old man suffered traumatic amputation of his II〜V fingers from zone 5 (metacarpal) due to severe burn on the job. Although his thumb was saved, he couldn't grasp or pinch anything due to acute thumb contracture and digit amputation. Therefore, a temporary hand prosthesis was made from the heat-reversible material for making hand splints. This allowed the patient to acclimate to living with a temporary hand prosthesis before the construction of the genuine artificial hand. Wearing the temporary hand prosthesis resulted in increased frequency of using the right upper limb during ADL, and improved overall satisfaction.
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