plastic surgery hand surgery

【診療Tips】手指の(1)安全肢位と(2)機能肢位の違いは?

resident
手指の(1)安全肢位と(2)機能肢位ってどう違うんですか?

この両者は混同しやすいよね。
medical advisor

 

(1) 安全肢位 safe or intrinsic-plus position

  • 手指の外固定を行う上で関節拘縮を生じさせない肢位
  • 手関節は背屈位10-20°、MCPJ屈曲70-90°、IPJ伸展0°、母指対立位
  • MCPJを伸展固定すると側副靱帯が短縮したままになるので伸展拘縮になる
  • PIPJを屈曲固定するとvolar plate、check rein ligamentが短縮したままになるので屈曲拘縮になる

 

(2) 機能肢位=良肢位 functional position

  • 関節が動かなくった場合に、日常生活動作において支障の少ない肢位
  • 手関節は背屈位10-20°、手指はボールを握るような肢位

 

ポイント

  • 安全肢位は、拘縮を来さない安全な肢位
  • 機能肢位は、関節が動かなくなった場合に最低限機能する肢位(ボールを握る形)

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Shimpei Ono (Plastic Surgeon)

Associate Professor, Department of Plastic and Reconstructive Surgery, Nippon Medical School. He specializes in hand and foot plastic surgery, microsurgery, and reconstructive surgery, and is involved in clinical practice, research, and education. His research interests include the development of movable prosthetic fingers, VR education, application of 3D ultrasound and medical imaging engineering, and emphasis on PROs. He also has an interest in art anatomy and medical illustration, and lectures and writes about the fusion of art and medicine. In his educational activities, in addition to teaching students and residents, he is also involved in international medical exchange and disaster medicine as the director of the Association for Southeast Asian Medical Research (Ajiken).

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