中华骨科杂志
中華骨科雜誌
중화골과잡지
CHINESE JOURNAL OF ORTHOPAEDICS
2008年
4期
317-320
,共4页
石膏%外科%外固定器%生物力学%病例对照研究
石膏%外科%外固定器%生物力學%病例對照研究
석고%외과%외고정기%생물역학%병례대조연구
Casts%surgical%External fixators%Biomechanics%Case-centrel studies
目的 测量腕动力型支具与石膏管型的内部压力并进行比较.方法 健康志愿者20名,均为女性,年龄26～44岁,平均38.4岁.所有受试者均接受传统的肘下石膏固定和腕动力型支具固定,将腕关节制动于中立位.对于每一名受试者,石膏和支具的使用顺序均为随机.采用标准骨科石膏技术,先在前臂无张力地打一层棉衬垫,之后使用玻璃纤维石膏绷带将受试者的腕关节制动于中立位并塑形,石膏的近端位于肘下,远端位于远侧掌横纹,即掌指关节处,以保证手指的正常活动.分别在手指中立位、伸直位以及握拳时,于手背、尺骨茎突、桡骨远端背侧、前臂中部、手掌、桡骨远端掌侧、屈肌群肌腹、伸肌群肌腹等8个点测量石膏/支具内压力,并进行比较.结果 中立位、手指伸直及握拳时,所有8个测试点除尺骨茎突在手指伸直位外,其余各测试点在手指处于不同状态时测得的压力腕动力型支具均高于石膏管型固定.三点加压的关键点,即桡骨远端背侧、桡骨远端掌侧及前臂中部,在中立位及手指进行伸直-握拳全范围活动时测得的内部压力动力型支具始终高于石膏管型固定.结论 腕动力型支具内部各测试点的压力(除尺骨茎突外),均高于石膏管型固定.腕动力型支具可在手与前臂之间施加持续的牵引作用力.
目的 測量腕動力型支具與石膏管型的內部壓力併進行比較.方法 健康誌願者20名,均為女性,年齡26～44歲,平均38.4歲.所有受試者均接受傳統的肘下石膏固定和腕動力型支具固定,將腕關節製動于中立位.對于每一名受試者,石膏和支具的使用順序均為隨機.採用標準骨科石膏技術,先在前臂無張力地打一層棉襯墊,之後使用玻璃纖維石膏繃帶將受試者的腕關節製動于中立位併塑形,石膏的近耑位于肘下,遠耑位于遠側掌橫紋,即掌指關節處,以保證手指的正常活動.分彆在手指中立位、伸直位以及握拳時,于手揹、呎骨莖突、橈骨遠耑揹側、前臂中部、手掌、橈骨遠耑掌側、屈肌群肌腹、伸肌群肌腹等8箇點測量石膏/支具內壓力,併進行比較.結果 中立位、手指伸直及握拳時,所有8箇測試點除呎骨莖突在手指伸直位外,其餘各測試點在手指處于不同狀態時測得的壓力腕動力型支具均高于石膏管型固定.三點加壓的關鍵點,即橈骨遠耑揹側、橈骨遠耑掌側及前臂中部,在中立位及手指進行伸直-握拳全範圍活動時測得的內部壓力動力型支具始終高于石膏管型固定.結論 腕動力型支具內部各測試點的壓力(除呎骨莖突外),均高于石膏管型固定.腕動力型支具可在手與前臂之間施加持續的牽引作用力.
목적 측량완동력형지구여석고관형적내부압력병진행비교.방법 건강지원자20명,균위녀성,년령26～44세,평균38.4세.소유수시자균접수전통적주하석고고정화완동력형지구고정,장완관절제동우중립위.대우매일명수시자,석고화지구적사용순서균위수궤.채용표준골과석고기술,선재전비무장력지타일층면츤점,지후사용파리섬유석고붕대장수시자적완관절제동우중립위병소형,석고적근단위우주하,원단위우원측장횡문,즉장지관절처,이보증수지적정상활동.분별재수지중립위、신직위이급악권시,우수배、척골경돌、뇨골원단배측、전비중부、수장、뇨골원단장측、굴기군기복、신기군기복등8개점측량석고/지구내압력,병진행비교.결과 중립위、수지신직급악권시,소유8개측시점제척골경돌재수지신직위외,기여각측시점재수지처우불동상태시측득적압력완동력형지구균고우석고관형고정.삼점가압적관건점,즉뇨골원단배측、뇨골원단장측급전비중부,재중립위급수지진행신직-악권전범위활동시측득적내부압력동력형지구시종고우석고관형고정.결론 완동력형지구내부각측시점적압력(제척골경돌외),균고우석고관형고정.완동력형지구가재수여전비지간시가지속적견인작용력.
Objective To measure the intra-brace pressure in a new fabricated three-dimensional dynamic brace and the intra-cast pressure in the rigid plaster cast,and compare the differences of pressures between the brace and cast. Methods Twenty healthy adult female volunteers involved in this study,with the mean age of 38.4 years.ranged from 26 to 44 years.The forearms of every subject were applied a traditional Dlaster cast and a new fabricated forearm three-dimensional dynamic brace respectively to immobilize the forearm and hand with the wrist at a neutral position,and the applying order was randomly.The intra-brace and intra-cast pressures were recorded at 8 points by using the Fuji pressure sensitive film with the hand at a position of fist and that of extended fingers.The 8 points were the bakc of hand,styloid process of ulna,dorsum of distal radius,abdomen of middle forearm,palm,metacarpus of distal radius,flexion muscle belly,and extension muscle belly.The pressures were compared between intra-brace and intracast.Results The dynamic brace provided greater holding force at the hand and at the distal orearm than the Dlaster cast,and greater immobilization at the wrist while allowing full finger function and greater support to the forearm during the hand movements.Conclusion The results indicates that the new fabricated dynamic brace has measurableadvantages in the immobilization compared to the plaster cast,and especially it can Drovide a persistent traction between the hand and forearm which is important for preventing displacement of the fractured segments.The uew dynamic brace can provide a new technique and represent a further development in the conservative management.
