Author: Zhang, Chao
Title: Functional outcomes of patients with flexor tendon injuries in mainland China
Advisors: Li-Tsang, W. P. Cecilia (RS)
Degree: DHSc
Year: 2017
Subject: Hong Kong Polytechnic University -- Dissertations
Hand -- Wounds and injuries| -- Treatment -- China
Department: Faculty of Health and Social Sciences
Pages: xv, 98 pages : color illustrations
Language: English
Abstract: In mainland China, intervention programs for patients with flexor tendon injuries of the hand are lacking. Such patients often return home after surgery, only to return to the hospital for rehabilitation after a few months with a stiff hand. Most patients need re-surgery to release tendon adhesions, causing them further physical and psychological suffering. Therefore, in order for patients to receive effective post-surgery rehabilitation treatment and regain hand function more quickly, two studies were conducted to investigate the effectiveness of a new motion-based program for flexor tendon injury rehabilitation. In phase one, a survey was conducted to obtain an understanding of the hand function of patients after sustaining flexor tendon injuries. Eighty-one patients with flexor tendon injuries were recruited from a Chinese population in mainland China. The survey tool was divided into three parts. The first part included closed-ended questions concerning handedness, whether the dominant hand was injured, the time since injury, time since rehabilitation, and residual difficulties such as stiffness, pain, swelling, limitation of movement, increase or loss of sensation, and muscle weakness. The second part focused on the outcomes of post-surgery rehabilitation; specifically: 1) whether patients underwent post-surgery rehabilitation; 2) whether they conducted exercises using wrist-hand orthosis; and 3) the time elapsed between surgery and initiation of rehabilitation. This data was related to patients' awareness of rehabilitation and to the potential barriers to compliance, such as the costs of travelling to hospital and of follow-up rehabilitation services. Patients had an opportunity to make comments at the end of the survey. The third part employed the Quick DASH questionnaire to provide further information about patients' functional hand impairment.
In phase two, the aim was to set up a new early motion program with or without ultrasound-guidance. Patients were recruited into three study groups: 1) an early motion group, 2) an ultrasound-guided early motion group, and 3) a conventional care group (controls). For the assessment, total active movement, pain level, Jebsen-Taylor hand function tests, and the Simplified Chinese version of the Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH) were used to detect patients' hand function, hand dexterity, pain level, quality of life, and work and leisure conditions. The VAS scores were obtained at 1, 6, 8, and 12 weeks post-surgery, while the TAM and JTT scores were obtained 6, 8, and 12 weeks post-surgery. The DASH scores were obtained 1 and 12 weeks post-surgery for each group. Secondly, between-group differences were evaluated. To conclude, research on early intervention programs is still in its infancy and requires further investigation in mainland China. Early motion intervention in our study was found to greatly improve the hand function outcomes of patients with zone II flexor tendon injuries. The researcher has implemented a new early motion program to be launched in mainland China. Throughout this study, we advocate team management and early intervention regimes for patients with flexor tendon injuries in mainland China.
Rights: All rights reserved
Access: restricted access

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