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1.
Prog Orthod ; 21(1): 11, 2020 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-32363550

RESUMO

BACKGROUND: To compare dentoskeletal changes produced by the maxillary splint headgear and cervical headgear appliance during the early phase of Class II treatment, specially the initial overjet and upper incisors position. SUBJECTS AND METHODS: In this retrospective study, 28 Class II patients treated with the maxillary splint headgear (MSG, mean age 10.1 ± 1.9 years) and 28 Class II patients treated with cervical headgear (CHG, mean age 9.5 ± 1.9 years) were evaluated before and after treatment. Statistical comparisons between the two groups for cephalometric measurements at T1 and for T2-T1 changes were performed by means of independent sample t tests. RESULTS: The MSG showed a significantly greater reduction of the overjet in comparison to the CHG (- 2.4 mm and - 0.7 mm, respectively) and a significantly greater maxillary incisor uprighting (- 1.8 mm and 0.4 mm, respectively). In the MSG, overjet correction was due mainly to mandibular advancement (3.5 mm), while the correction of molar relationship (3.9 mm) was 64% skeletal and 36% dentoalveolar. In the CHG, the overjet correction was also more skeletal, due to mandibular growth (1.8 mm), while correction of molar relationship (3.5 mm) was 63% dentoalveolar and 37% skeletal. CONCLUSIONS: Both groups showed favorable skeletal mandibular changes, which was more significant in the MSG. Regarding tooth movement, the maxillary splint headgear was more effective in uprighting upper incisors and reducing the overjet than cervical headgear appliance.


Assuntos
Aparelhos de Tração Extrabucal , Má Oclusão de Angle Classe II , Cefalometria , Criança , Humanos , Maxila , Estudos Retrospectivos , Contenções , Técnicas de Movimentação Dentária
2.
J Clin Pediatr Dent ; 44(2): 71-78, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32271668

RESUMO

The objective of this manuscript was to review the literature on dental trauma splints and discuss materials used for splinting injured teeth in terms of their properties and conditions that are required for optimal stabilization. A literature search was conducted in the PubMed database with the keywords: "trauma splints", "dental trauma" and "traumatic dental injuries". The search was limited to English language publications. 42 publications fulfilled the inclusion criteria and were in accordance with the current recommendations. Optimal splinting of the teeth after trauma is one of the main predictors for pulpal and periodontal healing. The splints stabilize and protect the teeth, creating favorable conditions for the regeneration of the supporting tissues. Their application and removal should be easy and fast without any additional irritating of the surrounding tissues. The materials used to stabilize the injured teeth should keep the tooth in the original position, allowing for its physiological mobility.


Assuntos
Contenções , Mobilidade Dentária , Polpa Dentária
3.
Int J Prosthodont ; 33(3): 347-353, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32320190

RESUMO

Microstomia is a clinical condition of reduced mouth opening that can be acquired or congenital in origin. Problems associated with microstomia can be related to function, esthetics, or both. Management of microstomia due to facial burns is complex due to the presence of hypertrophic and contracture scars. Available treatment options can be broadly classified as surgical, nonsurgical, or both. Splints can be used to prevent the contraction of perioral musculature or to recuperate lost mouth opening. Various intraoral or extraoral, tooth-borne or tissue-borne, and static or dynamic appliances are in clinical use, but their designs are case specific. This case report explains the management of microstomia secondary to facial burns by using a dynamic splint in combination with intralesional injections of triamcinolone acetonide and hyaluronidase.


Assuntos
Queimaduras , Contratura , Microstomia , Estética Dentária , Humanos , Contenções
4.
Zhongguo Gu Shang ; 33(3): 241-6, 2020 Mar 25.
Artigo em Chinês | MEDLINE | ID: mdl-32233252

RESUMO

OBJECTIVE: To explore effects of Buyang Huanwu Decoction (, BYHWD) on early callus X-ray evaluation and level of serum alkaline phosphatase in elderly patients with Colles fracture after manual reduction and splint external fixation. METHODS: From October 2016 to October 2018, 60 elderly patients with Colles fractures were treated with manual reduction and splint external fixation and were divided into experimental group and control group. There were 30 patients in control group, including 15 males and 15 females; aged from 56 to 75 years old with an average of (67.81±5.41) years old; bone mineral density was (0.82±0.24) g/cm 2; patients were performed lift shoulders, bend and extend elbow joint, stretch five fingers and make a fist at 3 days after operation, 3 times daily for 1 month, 30 min once a time. There were 30 patients in experimental group, including 13 males and 17 females; aged from 57 to 77 years old with an average of (66.02±5.16) years old; bone mineral density was (0.76±0.23) g/cm2; patients performed rehabilitation exercise as control group and combined with BYHWD, 400 ml per dose, 2 times daily, 7 days as one course, totally 4 courses. RUSS scores at 14 and 28 days after reduction between two groups were compared, serum level of alkaline phosphatase (ALP) and serum calcium concentration were observed at immediately, 14 and 28 days after reduction. RESULTS: The patients between two groups were successfully fixed without re fractures and complications occurred. The patients were followed up for 30 to 35 days with an average of (31.60±1.03) days. RUSS score in experimental group at 14 and 28 days after reduction were 4.58±0.31 and 7.07±0.36, respectively; while in control group were 3.98±0.30 and 6.15±0.35, respectively; RUSS score in experimental group was significantly higher than that of control group. Serum alkaline phosphatase concentrations in experimental group at immediately, 14 and 28 days after reduction were (90.62±12.19) mmol/L ,(105.40±11.63) mmol/L, and (160.86±35.77) mmol/L respectively; while in controlgroup were (91.27±13.52) mmol/L ,(94.60±11.10) mmol/L ,(144.17±26.27) mmol/L respectively; there was no statistically difference between two groups at immediately; and had statistically differences between two groups at 14 and 28 days after reduction. There was no significant difference in serum calcium concentration between two groups at immediately, 14 and 28 days after reduction. CONCLUSION: BYHWD for elderly patients with Colles fracture could promote early formation of callus, effectively increase concentration of serum alkaline phosphatase and promote fracture healing.


Assuntos
Fratura de Colles , Medicamentos de Ervas Chinesas , Idoso , Fosfatase Alcalina , Fratura de Colles/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Contenções , Raios X
5.
Medicine (Baltimore) ; 99(17): e19858, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32332644

RESUMO

This study aims to evaluate the timing of surgery in surgically treated humeral shaft fractures, to investigate the effects of surgical time on fracture recovery and complications.This was a retrospective and observational study, based on patient data who underwent surgical treatment of humeral shaft fractures from January 2012 to January 2019. There were 52 patients (19 were women and 33 men) with traumatic humeral shaft fractures who were treated consecutively at our hospital.There was a statistically significant difference in time to start physical therapy, time between surgery and bone union, and time between bone fracture and bone union. The mean time to start physical therapy in group 1 was 6.5 weeks (range, 5-12 weeks), it was 10 weeks (range, 6-14 weeks) in group 2 (P < .001). The mean time between surgery and bone union in group 1 was 14.58 weeks (range, 12-20 weeks), it was 17.4 weeks (range, 8-30 weeks) in group 2 (P: .009). The mean time between bone fracture and bone union in group 1 was 113.2 days (range, 86-114 days), it was 179.2 days (range, 89-355 days) in group 2 (P < .001).Classically the first treatment option for humerus shaft fractures is conservative if there is no absolute surgical indication. Surgical treatment may be the first option if patients want to return to early everyday life. Delayed surgery means delayed physical therapy and this means delayed recovery and return to everyday life. In today's technology world, it should be discussed that the initial treatment of uncomplicated humerus shaft fractures is a conservative treatment.


Assuntos
Fraturas do Úmero/cirurgia , Tempo para o Tratamento , Adulto , Idoso , Redução Fechada/métodos , Tratamento Conservador , Feminino , Consolidação da Fratura , Humanos , Fraturas do Úmero/terapia , Masculino , Pessoa de Meia-Idade , Modalidades de Fisioterapia , Cuidados Pós-Operatórios , Recuperação de Função Fisiológica , Estudos Retrospectivos , Contenções , Adulto Jovem
6.
Int J Comput Dent ; 23(1): 11-16, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32207457

RESUMO

AIM: The present study aimed to evaluate intraoral microsensors for the objective measurement of patient compliance during splint therapy and to comparatively analyze the duration of mandibular and maxillary splint application in patients with myofascial pain. MATERIALS AND METHODS: Thirty-two patients with sole myofascial pain without limited opening (Research Diagnostic Criteria for Temporomandibular Disorders [RDC/TMD] Ia) were divided into two groups. To ensure patient comparability, all pressure-sensitive sites from the initial palpation were summarized as pain scores. The subjects in group 1 were treated with maxillary stabilization splints, and those in group 2 with mandibular stabilization splints. All splints were equipped with a microsensor without interfering static or dynamic occlusion. Wear pattern was recorded at three intervals of 30 days each. Following the observation period, the data were retrieved and statistically evaluated using multi-factor analysis of variance (ANOVA) and the Bland-Altman analysis. RESULTS: During the observation period, maxillary splints were applied in 44.4% and mandibular splints in 44.2% of the days. Regarding patient compliance, there was no significant difference between the maxillary and mandibular splints (P = 0.359). Patients with an increased pain score (P < 0.0001) and female patients (P = 0.013) wore their splints significantly more often. The wear time decreased over the observation period, whereas only the initial and terminal interval differed significantly across both the mandibular and maxillary splint groups (P < 0.0001). CONCLUSION: The microsensor used in the present study was an effective and reliable tool for monitoring patient compliance in patients with temporomandibular disorders (TMD). This method also allows for the reliable recording of intraoral splint application prior to the required bite elevations. The two types of splints analyzed in the present study had no significant influence on compliance.


Assuntos
Contenções , Transtornos da Articulação Temporomandibular , Feminino , Humanos , Mandíbula , Placas Oclusais , Dor , Resultado do Tratamento
7.
Medicine (Baltimore) ; 99(9): e19211, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32118722

RESUMO

BACKGROUND: To assess the efficacy and safety of plaster splint vs splints in the treatment of distal radius fractures (DRFs). METHODS: For a more comprehensive collection of original study, we mainly searched 9 electronic databases including the PubMed, Web of Science, EMBASE, Cochrane Library, Cochrane Central Register of Controlled Trials (CENTRAL), Clinical Trials.gov, the Chinese National Knowledge Infrastructure Database (CNKI), Wanfang Database, and VIP Database. The retrieval date of all databases is from the establishment to January 2019. In the aspect of assessing the quality of original research methodology, we mainly rely on the Cochrane risk bias assessment tool and GRADE assessment method. Revman 5.3 is used for statistical analysis. RESULTS: A total of 8 studies involving 717 participants were included. The results showed that effective rate (RR = 0.99, 95%CI 0.91 to 1.07, P = .83), reduction rate (RR = 1.00, 95%CI 0.93 to 1.07, P = .98), and complication rate of the plaster splint had no significant difference with the splint. In addition, for the excellent rate of treatment, subgroup analysis based on the included studies found that when the intervention period was 4 weeks, the plaster splint was better than the splint, and when the intervention period was more than 4 weeks, there was no significant difference between them. CONCLUSIONS: There is no sufficient evidence that plaster splint is superior to splint. However, according to current evidence, plaster splint is more effective than splint when the intervention period is shorter (4 weeks), and its advantage disappears when the intervention period is longer (> 4 weeks). It should be noted that the results of this study were influenced by the sample size and the quality of the included studies. More high-quality and well-controlled RCTs are needed to draw better conclusions in further study.


Assuntos
Fraturas do Rádio/terapia , Contenções , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
8.
Am J Trop Med Hyg ; 102(4): 905-909, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32100676

RESUMO

The aim of this feasibility study was to investigate how a 3D printer could be put to its best use in a resource-limited healthcare setting. We have examined whether a 3D printer can contribute to making prostheses, braces, or splints for patients who underwent major limb amputation because of complex wounds, for example, due to burns and subsequent scarring, accidents, conflicts, or congenital abnormalities. During a 3-month period, we investigated the benefits of customized, 3D-printed arm prostheses, splints, and braces in Sierra Leone. Using a handheld 3D scanner and a 3D printer, patient-specific medical aids were designed, manufactured, and tested. Questionnaires regarding patient satisfaction and the functionality of the prostheses were used for a short-term follow-up. Four esthetic prostheses were designed: two prostheses of the hand, one of the forearm, and one of the entire arm. Follow-ups were conducted after 3 to 4 weeks to investigate the quality of the prostheses and to complete a patient questionnaire. Even though the prostheses primarily fulfill esthetic needs, they also exhibit some degree of functionality. In addition, four splints for hands and arms were made to prevent scar contractures after skin transplantation. Finally, a brace for a young boy with kyphoscoliosis was manufactured. The boy has accepted the brace and will be followed up in the months to come. Long-term follow-up is required to prove the sustainability of the 3D-printed brace and prosthetic arms. Further research into how to sustain and refine this project is underway.


Assuntos
Membros Artificiais , Braquetes , Impressão Tridimensional/economia , População Rural , Contenções , Estudos de Viabilidade , Humanos , Pobreza , Serra Leoa
9.
J Rehabil Med ; 52(1): jrm00005, 2020 01 02.
Artigo em Inglês | MEDLINE | ID: mdl-31922205

RESUMO

OBJECTIVE: To determine current evidence for casting as an adjunct therapy following botulinum toxin injection for adult limb spasticity. DESIGN: The databases MEDLINE, EMBASE, CINAHL and Cochrane Central Register of Controlled Trials were searched for English language studies from 1990 to August 2018. Full-text studies using a casting protocol following botulinum toxin injection for adult participants for limb spasticity were included. Studies were graded according to Sackett's levels of evidence, and outcome measures were categorized using domains of the International Classification of Disability, Functioning and Health. The review was prepared and reported according to PRISMA guidelines. RESULTS: Five studies, involving a total of 98 participants, met the inclusion criteria (2 randomized controlled trials, 1 pre-post study, 1 case series and 1 case report). Casting protocols varied widely between studies; all were on casting of the lower limbs. There is level 1b evidence that casting following botulinum toxin injection improves spasticity outcomes compared with stretching and taping, and that casting after either botulinum toxin or saline injections is better than physical therapy alone. CONCLUSION: The evidence suggests that adjunct casting of the lower limbs may improve outcomes following botulinum toxin injection. Casting protocols vary widely in the literature and priority needs to be given to future studies that determine which protocol yields the best results.


Assuntos
Toxinas Botulínicas Tipo A/efeitos adversos , Terapia Combinada/métodos , Extremidades/irrigação sanguínea , Espasticidade Muscular/terapia , Modalidades de Fisioterapia/instrumentação , Adulto , Humanos , Masculino , Contenções
10.
Unfallchirurg ; 123(2): 126-133, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-31915878

RESUMO

BACKGROUND: The ideal surgical and postoperative treatment for flexor tendon injuries, especially in zone 2, is still subject to continuous modifications and professional discussions. OBJECTIVE: Presentation of established rehabilitation concepts, specific problems and new treatment approaches with practical recommendations for application. MATERIAL AND METHODS: Comparison of commonly used treatment concepts by assessing surgical flexor tendon repair, splint choice and clinical application in patients. Discussion of new surgical approaches and standards and their influence on postoperative therapy after flexor tendon injuries. RESULTS: The Washington regimen has retained its status as the standard in the current follow-up treatment of flexor tendon injuries. New suture materials and techniques enable early active rehabilitation of sutured flexor tendons with good clinical results, such as increased range of motion for interphalangeal joint extension and improved distal interphalangeal joint flexion with overall acceptable frequencies of suture rupture. CONCLUSION: A stable tendon repair with smooth gliding is the foundation for treatment after flexor tendon injuries. After intraoperative active digital extension-flexion testing of the sutured tendon an early active rehabilitation approach should follow. New splint designs in combination with primary stable tendon suture techniques have the potential to improve the postoperative outcome, presupposing a reliable cooperation of the patient.


Assuntos
Traumatismos dos Dedos , Traumatismos dos Tendões , Traumatismos dos Dedos/reabilitação , Traumatismos dos Dedos/cirurgia , Humanos , Amplitude de Movimento Articular , Contenções , Técnicas de Sutura , Traumatismos dos Tendões/reabilitação , Traumatismos dos Tendões/cirurgia
11.
J Pediatr Orthop ; 40(2): e122-e126, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31045629

RESUMO

BACKGROUND: There are multiple methods of achieving upper extremity immobilization after pediatric elbow injuries; however, no biomechanical study has established an optimal construct. The goal of this study was to compare the strength of commonly used long arm splints and to evaluate the effect of reinforcing plaster splints with side struts. METHODS: Five categories of long arm posterior slab splints were tested: 4-inch plaster without side struts, 4-inch plaster with a medial side strut, 4-inch plaster with medial and lateral side struts, 5-inch plaster without side struts, and 4-inch fiberglass splint material without side struts. There were 4 splints in each group. As a control, 4 half fiberglass long arm casts were also tested. Each splint or cast was mounted on a single-column tensile tester and a 3-point bending load was applied to simulate an extension moment at the elbow. The maximum load before failure was measured and an ANOVA model was used to analyze the differences between groups. Additionally, a retrospective chart review was performed of pediatric patients who were immobilized postoperatively in a long arm plaster splint with side struts. We collected data on patient age, type of fracture, time from splint application in the operating room to removal in clinic, length of follow-up, and any complications. RESULTS: The 4-inch plaster splints reinforced with 2 struts had the highest average maximum load to failure (731±143 N), which was significantly higher than the 4-inch plaster splints with one strut (505±48 N) (P=0.01) and the 4-inch plaster splints without struts (100±10 N) (P<0.001). The half fiberglass casts failed at an average maximum load of 655±96 N, however there was no statistically significant difference compared with 4-inch plaster splints with 2 struts (P=0.10). The 5-inch plaster splints without side struts failed at a greater average maximum load (341±110 N) compared with the splints constructed with fiberglass material without side struts (233±61 N) (P=0.03). A total of 140 patients were identified in the retrospective review. Splint-related complications occurred in 2 patients. CONCLUSIONS: The addition of both 1 and 2 side struts to a 4-inch long arm plaster splint significantly increased the load to failure. The strength of 4-inch plaster splints with 2 side struts was comparable to that of half fiberglass casts. LEVEL OF EVIDENCE: NA (biomechanical study).


Assuntos
Moldes Cirúrgicos , Contenções , Fenômenos Biomecânicos , Criança , Pré-Escolar , Articulação do Cotovelo/lesões , Falha de Equipamento , Vidro , Humanos , Fraturas do Úmero/terapia , Masculino , Fraturas do Rádio/terapia , Estudos Retrospectivos , Contenções/efeitos adversos , Resistência à Tração
12.
J Oral Rehabil ; 47(3): 307-312, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31557342

RESUMO

The efficacy of a combination treatment of arthrocentesis and stabilisation splint for patients with bilateral anterior disc displacement without reduction (ADDWoR) and erosive change of the TMJ remains controversial. To evaluate clinical outcomes of patients with ADDWoR and erosive change of the TMJ after performance of unilateral arthrocentesis and stabilisation splint therapy. A retrospective study of 44 patients (37 females, 7 males, mean age of 34 years) with bilateral ADDWoR and erosive change of the TMJ were included in this study. Their clinical outcomes before and after arthrocentesis and stabilisation splint therapy were compared. Evaluation criteria were as follows: (a) Maximal mouth opening (MMO); (b) Right and left maximal lateral movement (RLM, LLM) and maximal protrusive movement (PM); (c) Visual analog scale (VAS) pain score during MMO, RLM, LLM and PM; and (d) VAS pain score during palpation of masticatory muscles. Wilcoxon signed-rank test, Mc Nemar test and paired t test were used for statistical analysis. Differences in VAS pain score between arthrocentesis and non-arthrocentesis sites were not statistically significant except MMO and LLM (P < .05) after 6 months. Differences in mean VAS pain scores for all variables between before arthrocentesis and 6 months follow-up in the arthrocentesis site were statistically significant. (P < .01). Unilateral arthrocentesis on more symptomatic TMJ and subsequent stabilisation splint therapy was highly successful for pain and achievement of normal range of mandibular movements in patients with both ADDWoR and bony change.


Assuntos
Luxações Articulares , Transtornos da Articulação Temporomandibular , Adulto , Artrocentese , Feminino , Humanos , Masculino , Medição da Dor , Amplitude de Movimento Articular , Estudos Retrospectivos , Contenções , Articulação Temporomandibular , Resultado do Tratamento
13.
J Oral Rehabil ; 47(2): 143-149, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31520538

RESUMO

The best treatment strategy for disturbing temporomandibular clicking sounds is not known. The aim was to evaluate the effect of exercise and bite splint therapy, respectively, in patients with symptomatic disc displacement with reduction. The study was a randomised clinical trial of subjects with temporomandibular joint (TMJ) clicking sounds with a reported severity/intensity of ≥4 on a numerical rating scale (0-10) and signs fulfilling the Research Diagnostic Criteria (RDC/TMD) for disc displacement with reduction. Thirty subjects each were randomised to bite splint, home exercise, or supervised exercise programme at the clinic. Two examiners (authors), blinded to the treatment modality, examined the same subject at baseline and at a 3-month follow-up. Non-parametric statistical methods were applied for analyses. A P-value <.05 was considered statistically significant. The dropout rate was highest in the home exercise group. About 50% of the participants reported improvement of their TMJ sounds with no significant difference between treatments. In the supervised exercise and the bite splint groups, approximately 2/3 of the patients reported 30% or more improvement of their TMJ sounds and half reported 50% improvement or more. The supervised exercise group also showed reductions in TMD pain, neck disability, mood disturbances and somatisation. Jaw exercise programmes and bite splint treatments had positive effects on TMJ clicking. The supervised exercise programme had an additional effect on the subject's well-being and thus may help to encourage patient's empowerment and coping strategies.


Assuntos
Luxações Articulares , Disco da Articulação Temporomandibular , Humanos , Placas Oclusais , Contenções , Resultado do Tratamento
14.
Int J Oral Maxillofac Surg ; 49(5): 686-690, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31601471

RESUMO

Navigation surgery plays an important role in modern craniomaxillofacial surgery, but it is difficult to apply navigation surgery to the mandible, due to its mobility. At present, headbands or headpins are widely used for fixation of the reference frame, and three strategies are generally used for the application of navigation surgery to the mandible. This article reports the application of a novel open position splint integrated with a reference frame and registration markers for mandibular navigation surgery as a fourth strategy. Using this custom-made integrated splint, a marker-based pair-point registration procedure was completed easily and non-invasively. Furthermore, the neurovascular canal tract could be easily identified, and the cyst, as well as the surrounding daughter cysts, could be removed with high accuracy. This strategy has potential for widespread clinical application in mandibular navigation surgery.


Assuntos
Procedimentos Cirúrgicos Ortognáticos , Cirurgia Assistida por Computador , Mandíbula , Contenções
15.
J Plast Surg Hand Surg ; 54(1): 33-39, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31502914

RESUMO

Recessive dystrophic epidermolysis bullosa (RDEB) is a congenital disease caused by a mutation in the COL7A1 gene and frequently results in hand contractures and pseudosyndactyly. Although multiple treatments exist that can improve the hand malformations, there are currently still no radical cures for this disease because of its high recurrence rate. The present study reports our experiences on how to improve hand deformities in 11 RDEB patients with surgical management and postoperative skin dressings. Hand function was substantially improved after complete release of pseudosyndactyly and achievement of favorable digital web spaces. Patients were followed up for two years, and nine of which showed slight decrease in hand function characterized by re-narrowed web spaces, digit adhesion and flexed metacarpophalangeal (MP) and interphalangeal (IP) joints, while the last two patients underwent hand reoperation one year after their initial surgery because of recurrence. In conclusion, our results show that surgical correction followed by skin dressing changes is an effective approach to improving mitten-hand malformations in RDEB patients.


Assuntos
Epidermólise Bolhosa Distrófica/cirurgia , Deformidades Adquiridas da Mão/cirurgia , Procedimentos Ortopédicos , Adolescente , Criança , Pré-Escolar , Epidermólise Bolhosa Distrófica/complicações , Feminino , Seguimentos , Deformidades Adquiridas da Mão/etiologia , Humanos , Masculino , Curativos Oclusivos , Modalidades de Fisioterapia , Cuidados Pós-Operatórios , Estudos Retrospectivos , Silicones , Contenções , Adulto Jovem
16.
J Oral Rehabil ; 47(2): 123-131, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31493297

RESUMO

BACKGROUND: Temporomandibular disorders (TMDs) include pain and dysfunction in masticatory muscles and temporomandibular joints (TMJs). Applied relaxation (AR) is a coping skill that may be applicable for treatment of TMD. OBJECTIVES: The aim of this randomised, controlled study was to evaluate the effectiveness of AR as compared to stabilisation splint (SS), for treatment of TMD during 12-month follow-up. METHODS: The data were derived from 96 university students seeking treatment due to TMD symptoms at Finnish Student Health Service in Finland. The subjects were randomly divided into two treatment groups: SS (n = 41) and AR (n = 51) groups. Clinical TMD examinations (a modified version of DC/TMD, Axis I) were performed for both the groups at baseline and 3-, 6- and 12-month follow-ups. Depressive and non-specific physical symptoms (NSPS) were estimated with Axis II questionnaire (RDC/TMD), and a number of other pain sites were screened at baseline and 12-month follow-up. Data were analysed by means of chi-square test for both groups on five variables, t test for VAS pain intensity and repeated measures ANOVA for palpation pain at follow-up points. Statistical significance was set on P < .05. RESULTS: Decrease in the number of painful masticatory muscles and TMJs and VAS on pain intensity did not differ between groups. During follow-up, NSPS and number of body pain sites decreased significantly more in the AR than the SS group. The dropout was 56 patients. CONCLUSION: Neither of the treatments showed more benefit in decreasing local TMD pain. AR gave more benefit on psychological well-being and general pain symptoms.


Assuntos
Dor Facial , Transtornos da Articulação Temporomandibular , Finlândia , Humanos , Medição da Dor , Contenções , Estudantes
18.
J Am Acad Orthop Surg ; 28(1): e20-e27, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31290757

RESUMO

Casts are commonly used for fracture management and postoperative immobilization in pediatric patients. However, cast immobilization is not without complications (eg, thermal injuries, pressure sores, infection, and neurovascular injury) and may be associated with additional costs and increased loss of school/work days for cast removal or other complications. The disadvantages of traditional casting can be minimized by alternative management strategies: waterproof casts to facilitate bathing and swimming; a Pavlik harness in infants, a single-leg spica cast, or flexible intramedullary nails to avoid complications with double-leg spica casts for femur fractures; and braces or splints to manage buckle and minimally displaced distal radius fractures, toddler's fractures, and stable foot/ankle fractures.


Assuntos
Braquetes , Moldes Cirúrgicos/efeitos adversos , Imobilização/instrumentação , Contenções , Criança , Humanos
19.
Dev Med Child Neurol ; 62(2): 252-258, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31225647

RESUMO

AIM: To investigate long-term development of hand function after repeated botulinum neurotoxin A (BoNT-A) and occupational therapy at a young age. METHOD: Twenty children with unilateral spastic cerebral palsy (CP) (14 males, six females; median inclusion age 3y 1mo, range 1y 11mo-4y 3mo) participated in this longitudinal study. Ten children received occupational therapy after a randomized controlled trial and 10 repeated BoNT-A plus occupational therapy during 1-year. The Assisting Hand Assessment (AHA) and active supination, assessed the following 3 years. The assessments were compared with data from a reference group to investigate development over time. RESULTS: The improvement in AHA (7.5 AHA units) after BoNT-A plus occupational therapy was maintained at final follow-up. The occupational therapy group, unchanged after 1-year, improved by 5 AHA units (96% confidence interval [CI] 2-10), thus there was no difference between the groups. Median active supination increased in comparison with the reference group. In the BoNT-A/occupational therapy group, 9 out of 10 (97.85% CI 45 115) children improved in active supination. In the occupational therapy group, 7 out of 10 (97.85% CI -2 to 68) children improved in active supination. No correlation between active supination and AHA was found. INTERPRETATION: Bimanual performance achieved after BoNT-A plus occupational therapy was maintained, while it increased by follow-up in the occupational therapy group, suggesting that combined intervention gave earlier access to bimanual skills. Active supination was unrelated to AHA. WHAT THIS PAPER ADDS: Children whose bimanual performance improved after botulinum neurotoxin A and/or occupational therapy, maintained skills or progressed during follow-up. Bimanual performance increased with age, similar to a quality-register reference group. Increased active supination after intervention improved at follow-up but was not related to bimanual performance.


Assuntos
Toxinas Botulínicas Tipo A/uso terapêutico , Paralisia Cerebral/terapia , Mãos , Fármacos Neuromusculares/uso terapêutico , Terapia Ocupacional , Contenções , Paralisia Cerebral/fisiopatologia , Pré-Escolar , Terapia Combinada , Feminino , Seguimentos , Mãos/fisiopatologia , Humanos , Lactente , Estudos Longitudinais , Masculino , Destreza Motora , Resultado do Tratamento
20.
Cranio ; 38(3): 187-195, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-30079809

RESUMO

Objective: The aim of this study was to conduct a systematic review on the effectiveness of occlusal splints for improving muscle strength. Occlusal splints are oral appliances that cause joint stabilization. Methods: A mix of medical and sports science terms was used to perform the search on several databases (Web of Science, Science Direct, SPORT Discus, PubMed, and Springer). Results: Twelve studies were reviewed, and their analysis indicates a trend pointing toward a limited interaction between the use of occlusal splints and improved muscle strength. Discussion: The extent of occlusal splints' impact on muscle strength is presently unknown. At this stage, there is no general agreement as to whether occlusal splints can be used as ergogenic aids. The number of studies on this specific topic and their different experimental designs precludes drawing more definite conclusions. Further research is warranted to elucidate possible changes resulting from occlusal splints during exercise.


Assuntos
Força Muscular , Placas Oclusais , Humanos , Contenções
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