小夹板对桡骨远端骨折的固定治疗效果分析

骨质疏松的老年人桡骨远端骨折发生的机会相对较大.对此临床上采用手法整复小夹板外固定大多可获得满意的效果.2005年至2010年10月间513例,采用手法复位小夹板固定桡骨远端骨折,取得了满意的效果.本文就小夹板对桡骨远端骨折的固定治疗的效果进行分析和总结,现作回顾性分析报告如下.     

Immediate and short-term effects of three commercial wrist extensor orthoses on grip strength and function in patients with rheumatoid arthritis

Objective . To investigate the immediate and shortterm effects of 3 commercial wrist orthoses on grip strength and function. Methods . Thirty-six patients with definite rheumatoid arthritis participated in the randomized, controlled, cross-over design study of 3 commercial wrist extensor orthoses. Dominant-hand dynamometric grip strength was assessed at both initial and followup sessions while splinted and nonsplinted. Functional impact was assessed using a written questionnaire. Results . All 3 commercial orthoses reduced grip strength when first donned. After a 1-week adjustment period, one orthosis, the Smith and Nephew Roylan D-Ring® (Roylan), afforded splinted grip strength equal to that of the nonsplinted grip strength. The other 2 orthoses continued to reduce grip strength, and afforded splinted grip strength significantly below that of the Roylan. The Roylan was deemed comfortable by more subjects than the other orthoses. Conclusions . The belief that commercial orthotic use increases grip strength, either immediately or after 1 week, is not supported by this study's data. Different styles of commercial wrist orthoses appear to have differing influence on splinted grip strength.     

数字化中医手法复位结合3D打印小夹板外固定治疗A型桡骨远端骨折的近期疗效观察

目的:探讨数字化中医手法复位结合3D打印小夹板外固定治疗A型桡骨远端骨折的近期疗效,探索中医手法复位的量化及小夹板固定的个性化改进。方法:病例均来自河北省沧州中西医结合医院门诊就诊的A型桡骨远端骨折患者,共50例,女22例,男28例;年龄25～75岁;左侧27例,右侧23例;分为治疗组和对照组,各25例。治疗组男13例,女12例;年龄(56.2±5.5)岁。治疗组患者治疗方法:首先,采用Mimics Research软件对获取的完整的患肢CT数据进行全方位分析,形成三维模型;然后,将患肢骨骼以及皮肤轮廓的STL格式三维模型分别导入至Materialise Magics 23.0软件中,对模型进行处理和修复,并模拟复位,记录位移数据形成“数字处方”,以此指导和量化中医手法操作;最后,应用3D打印的个性化小夹板进行固定治疗。对照组男15例,女10例;年龄(53.32±5.28)岁;给予中医手法复位结合传统小夹板固定。通过观察骨折临床愈合时间、骨折复位质量、治疗6周Gartland-Werley腕关节评分、治疗6周的X线参数评价(掌倾角、尺偏角、桡骨高度),比较两组临床疗效。结果:治疗组达到...     

正畸治疗中三种个别牙[牙合]垫的临床应用效果研究

目的：比较应用玻璃离子水门汀、京津釉质粘合剂、光固化复合树脂三种材料制作个别胎垫的临床应用效果。方法：分别用玻璃离子水门汀、京津釉质粘合剂、光固化复合树脂制作45例90个个别[牙合]垫，用磨耗脱落率、脱矿率进行性能评价。结果：光固化复合树脂组磨耗脱落率低，脱矿率三组间没有显著差异。结论：光固化复合树脂适合制作个别牙牙合垫。     

Finger dexterity and hand function: Effect of three commercial wrist extensor orthoses on patients with rheumatoid arthritis

Objective . To investigate the effect of 3 commercial wrist orthoses on finger dexterity and hand function of patients with rheumatoid arthritis (RA). Methods . Forty-two patients with definite RA participated in the cross-over study comparing 3 styles of commercial wrist orthoses. Finger dexterity and hand function of the dominant hand were assessed while splinted and unsplinted, at the initial session and after 1 week of intermittent orthosis use. Finger dexterity was assessed using two subtests from the Purdue Pegboard Test (Purdue) and hand function was assessed using the Jebsen-Taylor Hand Function Test (Jebsen-Taylor). Results . Both finger dexterity and hand function were reduced by splinting; men and women were affected similarly. There was no difference in finger dexterity or hand function afforded by the 3 orthoses. Results on both the Purdue and Jebsen-Taylor tests showed a significant learning effect across time. Conclusions . The 3 commercial wrist orthoses studied reduce dexterity similarly and significantly. When commercial wrist orthoses are to be used during tasks that require maximum dexterity, this reduction should be weighed against the known benefits of splinting.     

Management of acute open flexor tendon injuries of the hand and wrist: basic sciences,surgical factors and rehabilitation pertinent to optimizing outcome

Flexor tendon injuries to the hand and wrist represent a significant resource burden to the UK NHS. A good understanding of tendon basic science and repair techniques is crucial for the surgeon undertaking their repair and rehabilitation. Furthermore, this is a common topic assessed in the FRCS(Orth) examination. This article will summarize the basic science relating to tendon structure, physiology and injury. Additionally, it will present key surgical and rehabilitation factors relevant to clinical outcomes.     

Occlusal splints-types and effectiveness in temporomandibular disorder management

BackgroundOcclusal splints are routinely used in dental offices to diagnose and treat abnormalities of the masticatory system. There are different occlusal splints, each of which can address various conditions. They may treat individuals with temporomandibular disorders (TMDs) and bruxism or be used for occlusal stabilization and dentition wear reduction.MethodsThe literature in the National Library of Medicine's Medline Database was reviewed using the Mesh terms 'occlusal splints' AND 'Temporomandibular Disorders.ConclusionOcclusal splints can treat a wide variety of TMDs. They can treat bruxism, headaches, postural imbalances related to TMDs, and decreased vertical dimension of occlusion (VDO). However, there is no clear evidence that occlusal splints are superior to physiotherapy in treating TMDs. In the long-term follow-up, they were equally effective as other therapies.