ABSTRACT
The current study aimed to design a patellar-tendon-bearing (PTB) brace capable of measuring and quantifying weight offloading on the tibia. The PTB brace was designed with off-loading mechanism on the tibia with features, including ankle joint, vertical sliding adaptor, vertical sliding piece, and upper connector of load cells to PTB brace. Also, the present study investigated the effect of brace on 20 healthy individuals under 8 different off-loading conditions, based on measuring the vertical distance between the calf shells and foot plate through a sliding adapter at 0.5, 1, 1.5, 2, 2.5, 3, and 3.5 cm. The Pedar device and load cells embedded in PTB brace were used to determine the extent of offloading and assess the reliability and validity of brace. Increasing the vertical distance between the calf shells and the footplate can lead to a greater amount of offloading. Accordingly, off-loading ranged from a minimum of 16.5% at 0 cm position to a maximum of 60.48% at 3.5 cm position of sliding adapter. Percentage values of tibia off-loading in 8 conditions were not significantly different in Padar devices and PTB brace. Therefore, PTB brace load cells, as a valid method, can measure off-loading levels. When fabricating a PTB brace, a monitoring system with load cells is essential to measure the amount of tibial offloading, leading to readjustment if limb slides down inside the brace. Additionally, a component is needed to correctly position limb in off-loading condition. In the current study, sliding adapter of brace can provide that capability.
ABSTRACT
Background and Aim: One of the leading reasons that patients, particularly older persons, are brought to the orthopedic emergency room is a fracture at the end of the radius. In this study, a new traction method for distal radius fractures was compared with manual reduction. Methods: The census method was used in this clinical trial to study 45 patients (46 hands) who were referred to Hamedan Besat Hospital in 2021. Patients were randomly assigned to two groups. The manual reduction (pressure and traction by an assistant and a doctor) method was implemented in Group A, and the new traction procedure (pressure and traction by hardware or a device) was performed in Group B. The radiographic results of reduction in both groups were investigated and compared immediately and in the first and 6 weeks after surgery. Results: The following results were observed in the new and manual groups in the sixth week after surgery: average volar tilt: 4.19 ± 3.79 and 4.08 ± 3.88 (p = 0.926), radial angulation: 2.18 ± 1.27 and 2.21 ± 1.35 (p = 0.934), radial shortening: 10.52 ± 0.65 and 10.56 ± 0.68 (p = 0.828), radial inclination: 22.52 ± 2.46 and 22.71 ± 2.01 (p = 0.787), dorsal angulation: -5.89 ± 0.33 and 5.22 ± -1.91 (p = 1.00), ulnar variance: 1.66 ± 0.90 and 1.67 ± 0.81 (p = 0.958), and average pain score: 2.40 ± 0.68 and 2.47 ± 0.73 (p = 0.737). Conclusion: The new reduction procedure with hardware in patients with distal radius fractures showed the same effect as the traditional method based on pressure and traction by the assistant and doctor in terms of radiographic changes and pain score of the fracture site.