Новые возможности комплексной реабилитации больных с переломами дистального метаэпифиза лучевой кости при использовании системы полужесткой фиксации [Текст] / А. К. Рушай [и др.] // Травма. - 2019. - Том 20, N 1. - С. 120-126. - Библиогр. в конце ст.
MeSH-головна:
ЛУЧЕВОЙ КОСТИ ПЕРЕЛОМЫ -- RADIUS FRACTURES (реабилитация, хирургия)
ОРТОПЕДИЧЕСКИЕ ФИКСИРУЮЩИЕ УСТРОЙСТВА НАРУЖНЫЕ -- EXTERNAL FIXATORS (использование)
РЕАБИЛИТАЦИЯ -- REHABILITATION (методы)
ФИЗИЧЕСКАЯ КУЛЬТУРА ЛЕЧЕБНАЯ -- EXERCISE THERAPY (использование)
Анотація: В работе проведено сравнение характеристик системы фиксации переломов дистального метаэпифиза лучевой кости гипсовой лонгетой и полужесткой полимерной системы фиксации Softcast/Scotchcast. Выявлен ряд преимуществ последней. Конструктивные особенности полимерной фиксации позволили снизить уровень вторичных смещений. Преимущества проведения реабилитационных мероприятий при использовании полимерной повязки заключались в оптимальных условиях сокращения мышц, увеличенном объеме движений пальцев пораженной конечности, позволили проводить кинезотерапию даже в раннем иммобилизационном периоде в расширенном объеме. Определена эффективность предложенных мероприятий
Distal metaphyseal radius fractures (DMRF) are most common in female population aged 60 years and above — up to 40 % of all fractures. The main points in the DMRF treatment are reposition of the fragments and keeping them in the right position. Plaster cast is the historical and the most ancient method, which has not been forgotten and remains relevant at the present time. The introduction of surgical stabilization methods allowed us to obtain significant percentage of good results in the observation. However, for a number of reasons (contraindications for surgery, economic characteristics, etc.), the conservative treatment is leading for DMRF. Application of new fixation materials improves the results of the conservative treatment. One of the options is using a semi-rigid polymeric fixation system — Softcast/Scotchcast. Characteristics of DMRF fixation systems were compared with those of a plaster cast and Softcast/Scotchcast semi-rigid fixation system. It identifies the number of advantages of the last one. The design features of Softcast/Scotchcast semi-rigid polymer fixation system have reduced the percentage of forearm tissue edema with the need to unclench the bandage and the incidence of secondary displacements. Good rehabilitation results can be achieved only with a comprehensive therapy. The standard components of rehabilitation are physical exercises, therapeutic massage and physiotherapy. It was noted the importance of prevention using drug therapy and thermal asymmetric index ΔT. Its value was determined with individual characteristics of the clinical observation. Combined therapy is aimed at preventing neurodystrophic disorders and the development of contractures, early and complete restoration of the hand function. The advantages of rehabilitation with the use of a polymer bandage consist in creating the quite optimal conditions for muscle contraction and increasing finger movement activity in the affected limb. Characteristics of semi-rigid fixation and the design features of the polymer cast allow extending volume of the kinesiotherapeutic methods at the early immobilization period. The functional activity elevation was not accompanied with an increase in the pain sensations level on the visual analog scale. An effectiveness of different fracture fixation systems was determined with the DASH scale dynamic indexes. It shows a high usual activities at the immobilization stage of the treatment (a self-care possibility)
Дод.точки доступу:
Рушай, А. К.
Богданова, Л. В.
Богданова, К. И.
Ставицкий, А. Б.
Соловьев, И. О.
Пастернак, Д. В.
Лыжин, А. В.
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