Effects of early treatment with ultrashort wave combined with sequential pressure on functional recovery of deeply burned hands / 中华烧伤杂志

ABSTRACT

<p><b>OBJECTIVE</b>To study the effects of ultrashort wave combined with sequential pressure treatment on the functional recovery of deeply burned hands in the early stage of healed wounds in hands.</p><p><b>METHODS</b>Sixty-five patients with burn of unilateral hand were hospitalized from July 2012 to June 2013 in our center. Injured hands of 35 patients were treated with active movement, ultrashort wave, sequential pressure therapy, and pressure gloves, and the other 30 patients were treated with active movement and pressure gloves 10-31 days after the wounds were healed according to the will of patients. The former 35 patients were regarded as comprehensive treatment (CT) group, and the latter 30 patients were regarded as routine treatment (RT) group. Before treatment and 4 weeks after treatment, the appearance of injured hands was observed; the circumference of the proximal segment of thumb, index, and middle fingers and that of the palmar crease and wrist crease were measured to evaluate swelling of injured hand; score and grade of function of injured hands were evaluated with a Carroll Upper Extremity Functional Test. Data were processed with t test and rank sum test.</p><p><b>RESULTS</b>(1) Four weeks after treatment, appearance of 30 injured hands in group CT was improved, which was close to that of the normal hand of each patient, while contracture deformity of metacarpophalangeal joints and interphalangeal joints was observed in the other 5 injured hands. Four weeks after treatment, no obvious change in the appearance of 17 injured hands in group RT was observed compared with that before treatment, while hyperextension of metacarpophalangeal joints, flexion of interphalangeal joints, and adduction deformity of thumb were observed in the other 13 hands. (2) Four weeks after treatment, the circumferential values of the proximal segment of thumb, index, and middle fingers and the palmar crease and wrist crease of injured hands in group CT were respectively lower than those before treatment (with t values 3.26-4.24, P values below 0.01), and the circumferential values of the proximal segment of thumb and middle fingers and the wrist crease of injured hands in group RT were respectively lower than those before treatment (with t values 2.02-2.44, P values below 0.05). The difference values of circumference values of the proximal segment of thumb, index, and middle fingers and the palmar crease and wrist crease of injured hands between before treatment and 4 weeks after treatment were respectively (0.491 ± 0.022), (0.583 ± 0.089), (0.486 ± 0.021), (1.100 ± 0.076), (0.751 ± 0.053) cm in group CT, which were significantly higher than those in group RT [(0.306 ± 0.021), (0.277 ± 0.022), (0.320 ± 0.027), (0.700 ± 0.052), (0.483 ± 0.048) cm, with t values respectively 5.94, 3.11, 5.02, 4.22, 3.68, P values below 0.01]. (3) Four weeks after treatment, scores of function of injured hands in groups CT and RT were respectively higher than those before treatment (with t values respectively 14.40 and 4.00, P values below 0.001), and the grades of function of injured hands were respectively improved (with u values respectively 6.93 and 3.29, P values below 0.01). The difference value of scores of function of injured hands between before treatment and 4 weeks after treatment was (51.1 ± 2.2) points in group CT, which was significantly higher than that of group RT [(32.5 ± 4.8) points, t = 3.52, P < 0.001].</p><p><b>CONCLUSIONS</b>Ultrashort wave combined with sequential pressure and routine rehabilitation treatment of deeply burned hands in the early stage after wounds in hands are healed can obviously reduce the swelling of injured hands, which provides a favorable condition for active movements and systematic rehabilitation treatment later.</p>