Biomechanical Analysis of Scar in Dorsal Hand Associated with Metacarpal Joint Range of Motion

• Main Authors: Yu-Hsien Tu, 涂育
• Other Authors: Shun-Hwa Wei
• Format: Others
• Language: zh-TW
• Published: 2003
• Online Access: http://ndltd.ncl.edu.tw/handle/58937063186978804095

碩士 === 國立陽明大學 === 復健科技輔具研究所 === 91 === Background: Any thermal injury in hand area is though as serious injury because it may significantly affect hand function. Thermal injury in hand frequently causes many complications. These include skin pathological changes, hand deformity and decreases finger joint range of motion. Understanding skin biomechanical properties and decrease of finger joint range of motion are necessary in providing strategy in prevention of those complications. Methods and materials: Twenty one patients with thermal injury of dorsal hand voluntarily participated in the study. Cutometer (C&K electronic, Cologne, Germany) was used to measure skin biomechanical properties of each tested finger’s metacarpal bone. Finger joint range of motion was measured by using a manual goniometer. In order to reduce error from inter-subject variance, all measured values were normalized by each subject’s upper arm. Pearson correlation was used to examine the relationship among tested parameters. T-test was used to examine the difference between two tested parameters. Results: Little finger was found to have largest decrease in joint range of motion. The magnitude of decrease in range of motion was significantly affected by adjacent finger (active motion r= 0.69 to 0.95 and passive r= 0.53 to 0.94). The level of decrease of range of motion was significantly (p< 0.05) associated with several factors. These included injury areas, with or without hand surgery, hand deformity and injured contour such as circular or longitudinal burn injury. In biomechanical analysis of the scar properties, we hardly found any significant difference in tested fingers or tested areas. In general, NGE parameter seemed to be more sensitive than NME parameter. Discussions and conclusions: Decrease of finger range of motion was associated with several factors. These included injured area, surgery method, and scar contours. Decrease level of finger range of motion was believed to associate with post-injured time. Little finger was the easiest affected finger. This indicated that clinician must pay much attention in prevention of litter finger deformity after patient suffered with thermal injury. Adjacent finger might have greater limitation in joint range of motion if its adjacent finger seriously involved thermal injury. Based on our experience, we though skin biomechanical properties might not an easy method to be used for understanding joint deformity or decrease of joint range of motion in thermal injured hand. This might be due to test area was too little to indicate entire finger function.