腕动力型支具与石膏管型内部压力比较  

Comparison of the intra-cast pressures between a three-dimensional dynamic brace and the plaster cast

作　　者：刘沐青[1] 郭霞[1] 文效忠 

机构地区：[1]香港理工大学康复治疗科学系 [2]工业和系统工程系

出　　处：《中华骨科杂志》2008年第4期317-320,共4页Chinese Journal of Orthopaedics

基　　金：志谢：感谢香港理工大学博士后研究基金以及同济堂骨质疏松研究基金的大力支持.

摘　　要：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一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。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 plaster 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 intrabrace and intra-cast pressures were recorded at 8 points by using the Fuji pressure sensitive film with the hand at a position of clenched fist and that of extended fingers. The 8 points were the bake 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 forearm than the plaster 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 measurable advantages in the immobilization compared to the plaster cast, and especially it can provide a persistent traction between the hand and forearm which is important for preventing displacement of the fractured segments. The new dynamic brace can provide a new technique and represent a further development in the conservative management.

关 键 词：石膏 外科 外固定器 生物力学 病例对照研究 

分 类 号：R687.3[医药卫生—骨科学]