母指切断指に対する機能的スプリントの実際とその有用性

The reality of the splint toward the amputated-thumb and the effectiveness

要旨：母指切断後に，再建術が施行できなかった症例に対して，パイロット・スプリントを『機能的スプリント』として作製し，その装着によって，現職復帰を果たすことができた．

　本スプリントに関する作製手順の実際を示すとともに，装着の有用性を求めるために，握力，ピンチ力，およびSTEFを用いて検証した．

　スプリントの装着によって，握力は23.1％の改善を認め，ピンチカは3.5kgの筋力を発揮させることができた．またSTEFでは，25.8％の改善を得ることができた．

　さらにスプリントの完成に際して，我々が通気性や吸湿性などに関して試行錯誤してきた過程，および対処方法を示した．

　With regard to functional loss, a wrong movement in an amputated-thumb area can cause very serious injury.

　Therefore, reconstruction of the amputated area is necessary, and this involves the developing of a "pilot-splint" before the operation, which includes simulations. "Pilot-splint" development leads to the development of the "functional splint," and attaching this new splint can satisfy incumbent-reversion needs. To verify effectiveness, we employed grasping power, pinch power, and STEF exercises.

　After attaching the splint, grasping power showed a 23.1% improvement, and pinch power showed a 3.5 kg improvement. STEF came in at 83 points with the splint attached but only 66 points when the splint was not attached.

　Furthermore, the patient, himself, verified the effectiveness of the splint when performing his duties at his work place.

　When the splint was completed, coping evaluations were conducted through processes relating to ventilation, hygroscopicity, and trial and error observations.

　It was then decided that the ventilation hole should remain as it did not decrease splint effectiveness. Damp-absorbent material was then added to the inside of the splint.

　There were no problems with elasticity, durability, or heat-resistance, and splint material was matched, as closely as possible, to the color of the skin.

　Therefore, trial and error observations will be carried out for now on. Thus, we have introduced an effective preparation process, and we hope to introduce further improvements in this process.