结合局部解剖手法复位治疗儿童尺桡骨下段骨折

目的探讨结合局部解剖手法复位治疗儿童尺桡骨下段骨折的疗效。方法回顾性分析我院2008年3月～2013年4月收治的156例儿童闭合性尺桡骨下段骨折,根据2011年5月前后采用不同的手法复位方式分为对照组84例和治疗组72例,对比分析两组患者的复位效果。结果治疗组和对照组总的优良率分别为93．1％,76．2％;Ⅰ型骨折的复位效果两组间差异无统计学意义（P〉0．05）,Ⅱ、Ⅲ型骨折复住效果治疗组优于对照组（P〈0．05）。结论结合局部解剖手法复位治疗儿童尺桡骨下段骨折复住效果好,临床应用价值高,可推广应用。     

The Clinical and Sonographic Effects of Kinesiotaping and Exercise in Comparison With Manual Therapy and Exercise for Patients With Subacromial Impingement Syndrome: A Preliminary Trial

Objective

The purpose of this study was to compare the effects of manual therapy with exercise to kinesiotaping with exercise for patients with subacromial impingement syndrome.

Methods

Randomized clinical before and after trial was used. Fifty-four patients diagnosed as having subacromial impingement syndrome who were referred for outpatient treatment were included. Eligible patients (between 30 and 60 years old, with unilateral shoulder pain) were randomly allocated to 2 study groups: kinesiotaping with exercise (n = 28) or manual therapy with exercise (n = 26). In addition, patients were advised to use cold packs 5 times per day to control for pain. Visual analog scale for pain, Disability of Arm and Shoulder Questionnaire for function, and diagnostic ultrasound assessment for supraspinatus tendon thickness were used as main outcome measures. Assessments were applied at the baseline and after completing 6 weeks of related interventions.

Results

At the baseline, there was no difference between the 2 group characteristics (P > .05). There were significant differences in both groups before and after treatment in terms of pain decrease and improvement of Disability of Arm and Shoulder Questionnaire scores (P < .05). No difference was observed on ultrasound for tendon thickness after treatment in both groups (P > .05). The only difference between the groups was at night pain, resulting in favor of the kinesiotaping with exercise group (P < .05).

Conclusion

For the group of subjects studied, no differences were found between kinesiotaping with exercise and manual therapy with exercise. Both treatments may have similar results in reducing pain and disability in subacromial impingement in 6 weeks.     

The Most Effective Time Interval for Repositioning Subjects at Risk of Pressure Sore Development: A Literature Review

This review analyzed 17 studies to establish the repositioning time interval that is most effective in preventing pressure sores in at‐risk individuals. Because the studies did not provide strong evidence to support any specific time interval, we suggest that the commonly recommended 2‐hour interval be the starting point for individual turning schedules. The 2‐hour interval should be shortened or expanded according to each individual's susceptibility to pressure sores.     

"Spontaneous" repositioning of migrated teeth following periodontal surgery

Abstract The paper presents 2 cases of “spontaneous” repositioning of anterior teeth following periodontal surgery. In view of the reported cases, the present approach to orthodontic treatment of periodontal patients is questioned. It is suggested that the subject of “spontaneous” repositioning deserves more attention and that documentation and research are needed to elaborate on the subject in order to establish a sound approach to orthodontic intervention in periodontal cases.     

Physiological reactions during brush saw operation

Summary An experimental study of the physiological effects of brush saw operation was performed on eight professional agricultural workers. The experiments were carried out in the field under practical working conditions. Aesthesiometric thresholds (two-point discrimination and depth sense perception), manipulative dexterity, pinch grip force and fingertip skin temperature (FST) were measured before and after exposure to different combinations of static load (handle holding), noise and vibration by using new production brush saws for 5 to 15 min. The changes in the peripheral circulatory, sensorineural and muscular functions of the brush saw workers were not found to be significantly different under the various exposure conditions. Static load accounted for the major part of the changes in aesthesiometric thresholds, pinch grip force and FST after brush saw operation. With respect to baseline measurements, no significant difference in manipulative skill was observed after each exposure period. The weighted vibration accelerations from the right and left handles of a brush saw were 3.13 and 1.80 m/s², respectively. The assessment of brush saw vibration exposure according to ISO 5349 and the results of FST measurements were consistent with the findings of some epidemiological surveys indicating a low risk of vibration-induced white finger among brush sawyers. This investigation pointed out that the increase in the aesthesiometric thresholds was mainly determined by handle holding, and that the reduction in gripping force during actual work was related to the duration of brush saw operation. Therefore, prolonged static overload on the nerves, muscles and joints of the hand-arm system could explain the increased risk of musculoskeletal and sensorineural disorders found among brush saw users.     

良性发作性位置性眩晕的临床特点及Epley复位法治疗

目的探讨良性发作性位置性眩晕(BPPV)的临床特点和诊治方案。方法总结12例BPPV患者的临床资料,并结合文献进行分析。结果BPPV临床特点是有潜伏期,短暂性,旋转性、转换性和疲劳性。D ix-Hallp ike测验是确诊的主要方法,Epe-ly耳石复位治疗有效。结论BPPV诊断容易、手法治疗简便有效。     

手法复位空心钉内固定治疗高龄股骨颈Garden Ⅲ／Ⅳ型骨折60例

目的：探讨用手法闭合复位空心钉内固定治疗80岁以上高龄股骨颈GardenⅢ、Ⅳ型骨折临床疗效。方法：分析我院自2004年－2009年共采用闭合复位加压空心钉内固定微创治疗60例高龄股骨颈骨折患者,术后随访观察骨折愈合及髋关节功能恢复情况。结果l49例获骨性愈合,4例不愈合,3例股骨头坏死。4例于术后2周内死于内科疾病,死亡病例均为年龄超过85岁患者。骨折愈合者术后髋关节功能Harris评分60～100分。术后髓关节功能恢复优良率94．64％。结论：在c臂机透视下手法复位空心钉内固定治疗高龄股骨颈骨折,手术创伤小、方法简便,复位固定可靠有效,可早期进行患肢功能练习,避免各系统疾病及压疮等并发症的发生。     

良性阵发性位置性眩晕43例管石复位法治疗分析

目的探讨管石复位法治疗良性阵发性位置性眩晕（benign paroxysmal positional vertigo,BPPV）的临床效果.方法确诊为BPPV的43例患者,判定半规管病变侧别和类型后,应用管石复位法治疗.结果最后一次治疗后1周进行疗效评估,43例BPPV的患者,治愈32例（74.4%）,有效9例（20.9%）,总有效率95.3%.结论管石复位法治疗良性阵发性位置性眩晕,具有操作安全、简单、疗效确切、费用低廉等特点.     

Lead perforation extending beyond the pericardium: Can we treat it percutaneously? Poke,pause, pray,and perform

Cardiac implantable electronic devices (CIED) are utilized in increasing number and in heterogeneous populations. With excellent training, checklists, and “muscle memory,” the implantation procedure is generally very safe and efficient. Nevertheless, significant and potentially life‐threatening complications can occur.