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Japanese Occupational Therapy Research Volume 20, Issue 2 （April 2001）

作業療法 20巻2号（2001年4月発行）

Japanese English

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◆実践ノート

牽引方向が指の動きに対応する牽引支点可動式ダイナミックスプリントの考案と臨床での患者適応について—2症例への使用経験より Clinical trial of an innovative dynamic splint: Shiraishi's changeable traction type and the clinical adaptation for the patient by the using experience for two cases 白石英樹 ¹ , 幅田智也 ¹ Hideki Shiraishi ¹ , Toshiya Habata ¹ ¹北里大学医療衛生学部作業療法学専攻 ¹Occupational Therapy Course, Faculty of Rehabilitation, Kitasato University School of Allied Health Sciences キーワード： (動的)スプリント , ハンドセラピィ , (スプリント療法) , Dynamic splint , Hand therapy , Splint therapy Keyword: (動的)スプリント , ハンドセラピィ , (スプリント療法) , Dynamic splint , Hand therapy , Splint therapy pp.171-178

発行日 2001年4月15日 Published Date 2001/4/15

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参考文献 Reference

要旨：従来の動的スプリントは，牽引力や牽引方向が指の伸展保持(牽引時)の状態で調整され，指の屈曲時には適正な牽引力や牽引方向が得られないといった問題が指摘されている．こうした問題を改善すべく新たに牽引支点可動式ダイナミックスプリントを考案し，臨床での適応する2症例への使用を行った．考案・試作した牽引支点可動式ダイナミックスプリントは，指の屈曲に対応して牽引方向が変化し，指節に対し適切な牽引方向を得ることができ，牽引したまま指を屈曲しても指関節腔を狭小させることなく，指の運動が可能であった．また臨床での2症例への使用より，指関節部骨折や関節拘縮のある患者に対して，従来型に比べ適応性があり有効であった．

　Recently, the frequency to make a splint in clinical area is increasing, and the splint therapy for hand injured patients is rising in importance.

　In dynamic splint, the direction and the force of traction-to-digit is usually set at the extended position of the finger. But the direction and the force cannot correspond to movement (flexion) of the finger. So, when the patient flexes his or her finger with a traditional-type dynamic splint, the direction of traction becomes unsuitable and the force of traction that is increased by finger flexion concentrates on the finger joint. For this reason, the repeating of joint exercise with a traditional-type dynamic splint has some bad influences on the joint of digit and secondary injury may occur with exercise using the traditional-type dynamic splint.

　So, I tried to make a new-type dynamic splint (an innovative dynamic splint: Shiraishi's changeable traction type). The changeable traction-type dynamic splint can change the direction of traction to the finger and can solve the problem of the traditional-type dynamic splint. Furthermore I had a chance to use the new-type dynamic splint for two patients who had their hands injured. Case 1 was a patient with a ring-phalanx head fracture, and case 2 was a patient with a PIP joint contracture after ulnar nerve palsy for a long time.

　According to my findings in these two clinical cases, the changeable traction-type dynamic splint is thought to be better to adapt to the patient who had the head fracture of the phalanx, intra-articular fracture, injury of the joint ligament, cartilage injury of the joint and joint contracture rather than the traditional-type dynamic splint.