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1.
Stomatologiia (Mosk) ; 100(1): 30-33, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33528953

RESUMO

THE AIM OF THE STUDY: Was to investigate the effectiveness of combined treatment with elastic bands and splints in patients with masticatory muscle hypertension. 103 patients (37 men and 66 women) aged from 21 to 65 years were examined. The diagnosis was made based on clinical and instrumental (electromyography) methods. Pain intensity was determined using a visual-analog scale (VAS). Elimination of masticatory muscle hypertension in patients of the first group (51 people) was carried out using only splints while patients of the second group (52 people) had a combined therapy with elastic bands and splints. In the second group of patients reliable reducing of pain intensity was observed by day 14 from the start of therapy (4.54±0.5 points), while in the first group of patients it was discovered only by day 21 (5.08±0.6 points). Reliable changing of the bioelectrical activity of masticatory muscles in the second group of patients was observed by the beginning of second week from the start of preliminary therapy, while in the first group of patients it was discovered only by the third week. Thus, the proposed method of masticatory muscles hypertension treatment using elastic bands and splints has features, favorably distinguish it from the other methods of the therapy, because it provides sparing functioning condition for masticatory muscles.


Assuntos
Hipertensão , Contenções , Adulto , Idoso , Eletromiografia , Feminino , Humanos , Hipertensão/terapia , Masculino , Músculo Masseter , Músculos da Mastigação , Pessoa de Meia-Idade , Adulto Jovem
3.
Clin Oral Investig ; 25(3): 1525-1534, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33409688

RESUMO

OBJECTIVES: Angle Class II malocclusions including a retrognathic mandible are the most frequent orthodontic problems. Both removable and fixed functional appliances can be used for mandibular advancement. Mandibular advancement after treatment with any fixed functional appliance has numerous therapeutic effects, such as stretching of masticatory muscles, ligaments, membranes and surrounding soft tissues, thus causing positional changes of the hyoid bone and epiglottis. This retrospective study investigates and compares treatment effects upon epiglottis- and hyoid bone position and posterior airway space in class II patients who received mandibular advancement through two different cast splint fixed functional appliances. MATERIAL AND METHODS: Two groups of 21 patients each ('Functional Mandibular Advancer' (FMA) and Herbst appliance) were investigated. The same experienced orthodontist performed the treatment in all patients, employing a single-step advancement protocol. The mandible always received initial protrusion into an edge-to-edge position. Conventional lateral cephalograms were available pre-treatment (T1) and immediately after appliance removal (T2) for all patients. The measurements comprised (I) hyoid bone, (II) epiglottis or (III) posterior airway space. Treatment-related changes were analysed with one-sample Student's t tests for intragroup comparisons and independent Student's t tests for intergroup comparisons. Statistical significance was set at p < 0.05. RESULTS: Measurements of the hyoid bone showed mostly increases for both appliances after treatment. Intergroup comparisons were not significant for FMA patients but significant for selected measurements in Herbst appliance patients. Intergroup comparisons showed insignificant changes. The posterior airway space was always insignificantly increased after treatment. The greatest increase was found caudally. Intergroup comparisons showed insignificant changes. CONCLUSIONS: Both fixed functional appliances cause an anterior and caudal displacement of epiglottis and hyoid bone and enlarge the posterior airway space. The therapeutic effects of the Herbst appliance are slightly larger, although not significantly. CLINICAL RELEVANCE: Treatment with either Herbst appliance of FMA alters the hyoid bone position and enlarges the posterior airway space. Still, long-term data are as yet unavailable; it remains unknown if the effects upon posterior airway space remain stable, and if a resulting posterior airway space enlargement may have clinical influence upon obstructive sleep apnoea syndrome.


Assuntos
Má Oclusão de Angle Classe II , Aparelhos Ortodônticos Funcionais , Cefalometria , Epiglote , Humanos , Osso Hioide , Má Oclusão de Angle Classe II/terapia , Mandíbula , Aparelhos Ortodônticos Fixos , Estudos Retrospectivos , Contenções
4.
Ann Emerg Med ; 77(2): 163-173, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33500115

RESUMO

STUDY OBJECTIVE: In patients with a distal radius buckle fracture, we determine whether home removal of a splint and physician follow-up as needed (home management) is noninferior to primary care physician follow-up in 1 to 2 weeks with respect to functional recovery. We also compare groups with respect to health care and patient-level costs. METHODS: This was a noninferiority randomized controlled trial conducted at a tertiary care children's hospital. Eligible patients were randomized to home management versus primary care physician follow-up and received telephone contact at 3 and 6 weeks after the index ED visit. Functional recovery was measured with the Activities Scale for Kids-performance, and participants reported wrist-injury-related health care interventions and expenses. The primary outcome was a comparison of the performance score between groups at 3 weeks. RESULTS: We enrolled 149 patients with mean age 9.5 years (SD 2.7 years), and 81 (54.4%) were male patients. Of the 133 patients (89.3%) with completed 3-week follow-up, the mean Activities Scale for Kids-performance score was 95.4% in the home management group (n=66) and 95.9% in the primary care physician follow-up group (n=67) (mean difference -0.4%; lower bound of the 95% confidence interval -2.4%). There was a mean costs savings of -$100.10 (95% confidence interval -$130.0 to -$70.20) in health care and -$28.2 (95% confidence interval -$49.6 to -$7.0) in patient costs in the home management versus primary care physician follow-up group. CONCLUSION: In patients with distal radius buckle fractures, home management is at least as good as primary care physician follow-up with respect to functional recovery. Implementation of the home management strategy also demonstrated significant cost savings.


Assuntos
Assistência ao Convalescente/economia , Assistência Domiciliar , Médicos de Atenção Primária , Fraturas do Rádio/terapia , Contenções , Criança , Redução de Custos , Feminino , Assistência Domiciliar/economia , Hospitais Pediátricos , Humanos , Masculino , Recuperação de Função Fisiológica
5.
Medicine (Baltimore) ; 99(50): e23612, 2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33327331

RESUMO

RATIONALE: Greenstick fractures most commonly occur in the pediatric population, especially in those under 10 years of age. Greenstick fractures are "extremely" rare in adults. This report presents the case of a greenstick fracture of the ulnar shaft in an adult following physical therapy for a radial neck fracture and ulnar shaft fracture post-internal fixation. Greenstick fracture can occur during physical therapy near the drill holes created during surgery. PATIENT CONCERNS: A 23-year-old man without any past medical history had sustained a greenstick fracture of the ulnar shaft after rehabilitation for a left radial and ulnar fracture that had been previously treated with internal fixation. DIAGNOSES: Five months after removal of the implants, the patient complained of left elbow tenderness and a "breaking" sound that occurred during physical therapy. The results of a subsequent X-ray revealed a greenstick fracture of the left ulnar shaft. INTERVENTIONS: Splinting of the fracture. OUTCOMES: After 2 months of splint fixation, the pain and range of motion in the affected arm were improved, and sequential X-rays showed callus formation and increased density of the ulnar shaft. LESSONS: Greenstick fractures occur not only in children but also in adults in specific circumstances. The cortex of long bones may be further weakened by drill holes created during surgery, and fractures may occur during physical therapy. During treatment, physicians, and therapists should pay more attention to the patient who has undergone implant removal to avoid greenstick fractures, especially in the locations near drill holes.


Assuntos
Modalidades de Fisioterapia/efeitos adversos , Fraturas da Ulna/diagnóstico , Diagnóstico Diferencial , Fixação Interna de Fraturas/efeitos adversos , Humanos , Masculino , Fraturas do Rádio/reabilitação , Fraturas do Rádio/cirurgia , Amplitude de Movimento Articular , Contenções , Fraturas da Ulna/diagnóstico por imagem , Fraturas da Ulna/etiologia , Adulto Jovem
6.
BMJ Case Rep ; 13(12)2020 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-33334764

RESUMO

Volar plate injuries are typically caused by hyperextension of the proximal interphalangeal joint. These injuries are usually seen in sports where the ball comes in direct contact with the hands. Forceful dorsiflexion of the finger caused by the speeding ball leads to volar plate avulsion. In cricket, such finger injuries predominantly occur in fielders trying to catch or stop the speeding ball with bare hands. We report two unusual cases of volar plate avulsion injury occurring in batsmen that occurred during 'gully cricket' (street-cricket). We propose the possibility of a novel contrecoup-type mechanism causing this type of injury in the two cases. Both were successfully managed with splinting and had excellent recovery without any residual deformity or instability.


Assuntos
Críquete/lesões , Traumatismos dos Dedos/diagnóstico , Placa Palmar/lesões , Contenções , Adulto , Traumatismos dos Dedos/etiologia , Traumatismos dos Dedos/terapia , Dedos/diagnóstico por imagem , Humanos , Masculino , Placa Palmar/diagnóstico por imagem , Resultado do Tratamento
7.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4628-4631, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019025

RESUMO

This paper demonstrates the design and manufacturing of a smart and connected internet-of-things collar system for the collection of behavioral and environmental information from working canines. The environmental factors of ambient light, ambient temperature, ambient noise levels, barometric pressure and relative humidity are recorded by the smart collar system in addition to behavioral information about barking incidences and activity levels. The data are collected from the sensors and transmitted via Bluetooth to the handler's smartphone where the custom app also acquires GPS positioning using the on-board smartphone sensors. The stored data on the smartphone are uploaded to the IBM Cloud once the user is connected to a WiFi network. The low power design of the smart collar system permits it to be used continuously for 27 hours with a 290 mAh lithium polymer battery. The cost of the system is low enough to let the handlers have multiple collars and exchange it if needed or recharge it overnight when not in use. This system is currently being scaled up to be tested on hundreds of canine puppies by a preeminent guide dog school in the US. As a result, the design emphasis here has been on the cost and power reduction, comfortable ergonomics, user friendliness, and robustness of data streaming. We expect the system to provide continuous quantitative data for improving guide dog training programs in addition to contributing the well-being of other working dogs in the future.


Assuntos
Smartphone , Animais , Coleta de Dados , Cães , Feminino , Registros , Contenções
8.
Rev. bras. ortop ; 55(5): 570-578, Sept.-Oct. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1144217

RESUMO

Abstract Objective To demonstrate the clinical outcomes and complication rates of the surgical release with a single posterior approach in the treatment of post-traumatic elbow stiffness. Methods A prospective study with patients submitted to surgery between May 2013 and June 2018 in a single center. The access to the elbow was made through the posterior approach. The patients were followed up by an occupational therapy team, and were submitted to a standardized rehabilitation protocol, with static progressive orthoses and dynamic orthoses. The primary outcome was the range of flexion-extension of the elbow after 6 months. Results A total of 26 patients completed the minimum follow-up of 6-months. The mean range of flexion-extension of the elbow at the end of 6 months was of 98.3 ± 22.0°, with an amplitude gain of 40.0 ± 14.0° in relation to the pre-operative period (p< 0.001). The average flexion-extension gain at the end of 6 months was of 51.7% ± 17.1% (p< 0.001). The mean pronosupination at the end of 6 months was of 129.0 ± 42.7° (p< 0.001). Half of the cases had moderate and severe stiffness in the pre-operative period, compared with 7.7% at 6 months post-operatively (p< 0.001). The mean score for the Mayo Elbow Performance Score (MEPS) and Disabilities of the Arm, Shoulder and Hand (DASH) instruments was 74.4 ± 16.8 points and 31.7 ± 21.9 points respectively (p< 0.001 for both). The visual analogue scale (VAS) score presented no statistically significant difference compared to the pre-operative period (p= 0.096). Complications were observed in 6 (23%) patients, and no new surgical procedures were necessary. Conclusions The surgical release of the elbow associated with a rehabilitation protocol is a safe technique, with satisfactory results and low rate of complications.


Resumo Objetivo Demonstrar os resultados clínicos e a taxa de complicações da liberação cirúrgica por via única posterior no tratamento da rigidez pós-traumática de cotovelo. Métodos Estudo prospectivo, com pacientes submetidos a cirurgia entre maio de 2013 e junho de 2018 em um único centro. Foi realizado acesso ao cotovelo por via posterior. O seguimento dos pacientes foi feito por uma equipe de terapia ocupacional, e eles foram submetidos a um protocolo de reabilitação padronizado, com órteses estáticas progressivas e dinâmicas. O desfecho primário foi a amplitude de flexoextensão do cotovelo após 6 meses. Resultados Um total de 26 pacientes completaram o seguimento mínimo de 6 meses. A média de flexoextensão do cotovelo, ao final de 6 meses, foi de 98,3° ± 22,0°, com um ganho de amplitude de 40,0° ± 14,0° em relação ao pré-operatório (p< 0,001). A média de ganho relativo de flexoextensão, ao final de 6 meses, foi de 51,7% ± 17,1% (p< 0,001). A média de pronossupinação, ao final de 6 meses, foi de 129,0° ± 42,7° (p< 0,001). Metade dos casos apresentava rigidez moderada e grave no pré-operatório, contra 7,7% aos 6 meses de pós-operatório (p< 0,001). A pontuação nos instrumentos Mayo Elbow Performance Score (MEPS) e Disabilities of the Arm, Shoulder and Hand (DASH) apresentou melhora estatisticamente significativa em relação ao pré-operatório, atingindo 74,4 ± 16,8 pontos e 31,7 ± 21,9 pontos, respectivamente. A escala visual analógica (EVA) não apresentou diferença estatisticamente significativa em relação ao pré-operatório (p= 0,096). Complicações foram observadas em 6 (23%) pacientes, não sendo necessária nova abordagem cirúrgica em nenhum paciente. Conclusões A liberação cirúrgica do cotovelo associada a protocolo de reabilitação é técnica segura, com resultados satisfatórios e baixa taxa de complicações.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Reabilitação , Contenções , Estudos Prospectivos , Contratura , Amplitude , Articulação do Cotovelo , Liberação da Cápsula Articular
10.
Bone Joint J ; 102-B(10): 1399-1404, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32993325

RESUMO

AIMS: The study was undertaken to compare the efficacy of Woodcast splints and plaster-of-Paris casts in maintaining correction following sequential manipulation of idiopathic clubfeet. METHODS: In this randomized prospective trial, 23 idiopathic clubfeet were immobilized with plaster-of-Paris casts and 23 clubfeet were immobilized with a splint made of Woodcast that encircled only two-thirds the circumference of the limb. The number of casts or splints needed to obtain full correction, the frequency of cast or splint-related complications, and the time taken for application and removal of the casts and splints were compared. RESULTS: The mean number of casts required to obtain full correction of the deformity (Pirani Score 0) was 4.35 (95% confidence interval (CI) 3.74 to 4.95) when plaster-of-Paris was used and 4.87 (95% CI 4.33 to 5.41) when the Woodcast splint was used (p = 0.190). The time required for application and removal of the Woodcast splint were significantly less than that required for application and removal of plaster-of-Paris casts (p < 0.001). Woodcast splint-related complications were not more frequent than plaster-of-Paris cast related complications. CONCLUSION: Though Woodcast splints covering two-thirds of the circumference of the lower limbs of infants were effective in maintaining the correction of clubfoot deformity during serial manipulation and casting treatment, the superiority of Woodcasts over plaster-of-Paris could not be established. Cite this article: Bone Joint J 2020;102-B(10):1399-1404.


Assuntos
Moldes Cirúrgicos , Pé Torto Equinovaro/terapia , Contenções , Sulfato de Cálcio , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Manipulação Ortopédica , Estudos Prospectivos
11.
Bone Joint J ; 102-B(10): 1405-1411, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32993326

RESUMO

AIMS: This exploratory randomized controlled trial (RCT) aimed to determine the splint-related outcomes when using the novel biodegradable wood-composite splint (Woodcast) compared to standard synthetic fibreglass (Dynacast) for the immobilization of undisplaced upper limb fractures in children. METHODS: An exploratory RCT was performed at a tertiary paediatric referral hospital between 1 June 2018 and 30 September 2019. The intention-to-treat population consisted of 170 patients (mean age 8.42 years (SD 3.42); Woodcast (WCG), n = 84, 57 male (67.9%); Dynacast (DNG), n = 86, 58 male (67.4%)). Patients with undisplaced upper limb fractures were randomly assigned to WCG or DNG treatment groups. Primary outcome was the stress stability of the splint material, defined as absence of any deformations or fractures within the splint during study period. Secondary outcomes included patient satisfaction and medical staff opinion. Additionally, biomechanical and chemical analysis of the splint samples was carried out. RESULTS: Of the initial 170 patients, 168 (98.8%) completed at least one follow-up, and were included for analysis of the primary endpoint. Both treatment groups were well-matched regarding to age, sex, and type and localization of the fracture. Splint breakage occurred in three patients (3.6%; 95% confidence interval (CI), 0.007% to 0.102%) in the WCG and in three children (3.5%, 95% CI 0.007% to 0.09%) in the DNG (p > 0.99). The incidence of splint-related adverse events did not differ between the WCG (n = 21; 25.0%) and DNG (n = 24; 27.9%; p = 0.720). Under experimental conditions, the maximal tensile strength of Dynacast samples was higher than those deriving from Woodcast (mean 15.37 N/mm² (SD 1.37) vs 10.75 N/mm² (SD 1.20); p = 0.002). Chemical analysis revealed detection of polyisocyanate-prepolymer in Dynacast and polyester in Woodcast samples. CONCLUSION: Splint-related adverse events appear similar between WCG and DNG treatment groups during the treatment of undisplaced forearm fractures. Cite this article: Bone Joint J 2020;102-B(10):1405-1411.


Assuntos
Traumatismos do Braço/terapia , Fraturas Ósseas/terapia , Contenções , Adolescente , Criança , Pré-Escolar , Feminino , Vidro , Humanos , Imobilização , Lactente , Análise de Intenção de Tratamento , Masculino , Desenho de Prótese , Madeira
12.
J Am Dent Assoc ; 151(10): 721, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32979948
13.
Dtsch Arztebl Int ; 117(26): 445-451, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32897182

RESUMO

BACKGROUND: After the surgical management of distal radius fractures (DRF) in older patients, further treatment with a splint often follows. It is unclear whether early mobilization might be superior to splinting in this group of patients, as it is in others. In this prospective, randomized, controlled trial, we attempted to determine whether early mobilization yields better outcomes. METHODS: 50 patients over age 70 with DRF were included in the trial. Group A (the splint group) was treated with postoperative immobilization, group B with early mobilization. Clinical follow-up examinations were performed at 2, 6, and 12 weeks and at 6 and 12 months. X-rays were obtained preoperatively, postoperatively, at 6 weeks, and at 6 months. The primary outcome parameter was the modified Mayo Wrist Score (MMWS) at 6 weeks. RESULTS: At 6 weeks, the functional outcome was better to a statistically significant extent in group B (MMWS; 65/100 vs. 55/100 [q25 : 55/40 - q75 : 70/70; p = 0.025]). No difference between the two groups was demonstrable in their further clinical course. The estimated regression model revealed a statistically significant effect of the method of treatment (p = 0.023). There were no differences in hand strength or in x-ray findings. DISCUSION: Early mobilization is associated with better wrist function on initial follow-up, without any demonstrable disadvantage with respect to secondary dislocation. The psychological benefit and protective function of wrist splinting in patients who are in danger of falling should nonetheless be investigated in further studies.


Assuntos
Deambulação Precoce , Fraturas do Rádio/reabilitação , Contenções , Idoso , Humanos , Estudos Prospectivos , Fraturas do Rádio/cirurgia , Resultado do Tratamento
14.
J Oral Rehabil ; 47(12): 1530-1537, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32841412

RESUMO

OBJECTIVE: To compare the manual time and preliminary clinical effects between the digital manufactured occlusal splints for sleep bruxism patients with those of traditional hard splints. METHODS: Sixteen individuals (18 to 44 y/o) with clinically diagnosed sleep bruxism were selected based on the inclusion criteria. All patients were divided into two groups, and a random control method was applied. Digital splints (test group) were designed and milled using CAD/CAM. Hard splints (control group) were made of transparent acrylic resin in laboratory office. The manual time spent including impression obtaining, splint production and clinical occlusal adjustment was recorded. A visual analog scale was used to report the subjective evaluations. The maximum depth loss and volumetric loss of the occlusal surface of splints in posterior tooth were measured. SPSS software was used for statistical analysis (P = .05). RESULTS: Comparing with control group, the manual time spent in test group was significantly less in all of three procedures (P < .001). The VAS scores for retention were not significantly different (P = .086), but the wearing comfort scores of test group were significantly higher (P < .001). Both maximum depth loss (P = .007) and volumetric loss in test group were significantly less than control group (P = .005). CONCLUSION: In the current study, the digitally manufactured splints exhibit significantly improved comfort and time efficiency than traditional hard splints. Moreover, the new milling material (PEEK) has better wear resistance than acrylic resins.


Assuntos
Bruxismo , Bruxismo do Sono , Resinas Acrílicas , Humanos , Cetonas , Placas Oclusais , Polietilenoglicóis , Bruxismo do Sono/terapia , Contenções
15.
Am J Occup Ther ; 74(5): 7405205050p1-7405205050p15, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804623

RESUMO

IMPORTANCE: Spasticity is one of the most common and disabling motor impairments after stroke. OBJECTIVE: To examine the evidence for the effectiveness of stretching interventions, including splinting, on reducing upper extremity spasticity, increasing hand function, and improving functional tasks for adults with poststroke spasticity. DATA SOURCES: Databases searched were MEDLINE, CINAHL, OTseeker, AgeLine, and the Cochrane Library; results were limited to studies published from 2004 to January 2017. STUDY SELECTION AND DATA COLLECTION: Following PRISMA guidelines, we included articles describing Level I-III studies with participants who were adults with upper extremity spasticity and received a stretching intervention. FINDINGS: Eleven articles describing 6 Level I and 5 Level III studies met inclusion criteria. CONCLUSION AND RELEVANCE: For reducing upper extremity spasticity, low strength of evidence was found to support the use of static splinting, strong strength of evidence was found for the use of stretching devices, and low strength of evidence was found to support the use of dynamic splinting; no evidence was found for manual stretching to address spasticity. For increasing hand function, moderate strength of evidence was found to support the use of static splinting, dynamic splinting, and manual stretching, and low strength of evidence was found for the use of stretching devices. For improving functional tasks, moderate strength of evidence was found to support the use of static splinting, dynamic splinting, and manual stretching, and low strength of evidence was found for the use of stretching devices. WHAT THIS ARTICLE ADDS: This updated synthesis summarizes the current literature regarding the effectiveness of stretching interventions to improve poststroke spasticity, hand function, and functional tasks.


Assuntos
Terapia Ocupacional , Acidente Vascular Cerebral/complicações , Adulto , Humanos , Espasticidade Muscular , Contenções
16.
Zhonghua Shao Shang Za Zhi ; 36(8): 751-753, 2020 Aug 20.
Artigo em Chinês | MEDLINE | ID: mdl-32829620

RESUMO

The maintenance of posture and anti-contracture treatment are the critical elements of comprehensive burn rehabilitation in the overall treatment period of pediatric burns. Although domestic experts in burn discipline have formulated guidelines for burn rehabilitation, the maintenance of posture and design and manufacture of splints for anti-scar contractures in children with burns are different from that for adults with burns in many ways. Starting with paying the attention to the rehabilitation problems in pediatric burns, especially considering the anatomical, psychological, and social behavior characteristics of children in developmental period, the author's team effectively applies splints to maximize the prevention of contractures in children and maintain and improve the range of their joint movements. The splints designed to prevent contractures in pediatric burns shall fit the small limb and meet their expected goals of rehabilitation. In each aspect of the production and use of splints, it is necessary to fully evaluate and consider the scar characteristics, growth and development status, activity level, and compliance of children, and adaptability and fixation methods of the splints, so as to select the appropriate splint type and formulate the wearing plan.


Assuntos
Queimaduras , Contenções , Criança , Cicatriz , Contratura , Extremidades , Humanos
17.
Univ. salud ; 22(2): 198-202, mayo-ago. 2020. graf
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1115969

RESUMO

Resumen Introducción: El labio y paladar hendido son malformaciones craneofaciales que se presentan en 1:1000 nacidos vivos en Colombia. Realizar un moldeado nasoalveolar previo a la cirugía favorece el reposicionamiento de los cartílagos nasales deformados y de los procesos alveolares. Objetivo: Dar a conocer a los profesionales la importancia de realizar moldeado nasoalveolar en un paciente con labio y paladar hendido antes de la intervención quirúrgica. Materiales y métodos: En la clínica odontológica de la Universidad del Sinú de Montería (Córdoba, Colombia), se atendió una paciente de 17 días de nacida que presentaba labio y paladar hendido completo unilateral izquierdo severo. Luego de diligenciar la historia clínica odontológica, se realizó placa de órtesis, que se cambió cada 15 días y se hizo el retoque del "tutor" cada 8 días. Resultados: La placa de órtesis permitió un moldeado naso alveolar, con el progreso en la alimentación y mejoras en el contorneado de los tejidos nasales, que mejoró la preparación para la operación de la hendidura a los 8 meses de edad. Conclusiones: La importancia del moldeado nasoalveolar en casos como el presentado, es propiciar mejores condiciones físicas, favoreciendo la ingesta de alimentos y beneficiando la apariencia física.


Abstract Introduction: Cleft lip and palate is a craniofacial birth defect that accounts for 1:1000 live birhts in Colombia. Performing nasoalveolar molding before surgery facilitates the reshaping of deformed nasal cartilage and alveolar processes. Objective: To make professionals aware of the importance of performing nasoalveolar molding in a patient with cleft lip and palate before surgical intervention. Materials and methods: A 17-day-old infant with a full left unilateral cleft lip and palate was treated at the dental clinic of the University of Sinú, Montería (Córdoba, Colombia). Once the dental clinical history was recorded, an orthosis plate was made. The plate was changed every 15 days and the molding appliance was repositioned every 8 days. Results: The orthosis plate promoted nasoalveolar molding, which facilitated feeding and improved the shape of nasal tissues. Consequently, this early intervention improved the preparation for the surgery of the cleft when the child reached 8 months of age. Conclusions: Nasoalveolar molding in patients with full cleft lip and palate is important to promote better physical conditions, which favor food intake and benefit their physical appearance.


Assuntos
Recém-Nascido , Fenda Labial , Modelos Anatômicos , Aparelhos Ortopédicos , Contenções , Fissura Palatina
19.
J Craniomaxillofac Surg ; 48(8): 786-791, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32620370

RESUMO

AIM: This study aimed to compare the effectiveness of a 3D-printed ear splint with that of a conventional thermoplastic ear splint after microtia reconstruction. METHODS: Patients who underwent ear elevation surgery with postauricular fascia coverage between October 2017 and October 2018 were included. They were randomly divided into the experimental group (3D-printed ear splint) and the control group (thermoplastic ear splint) and underwent routine postoperative rehabilitation and antiscar therapy. Splint therapy was initiated 4 weeks postoperatively and continued until 24 weeks postoperatively. The evaluated indices were the Vancouver scar scale score (VSS score), cranioauricular distance, patient compliance, complications (dermatitis, skin ulcers, skin necrosis), and patient satisfaction. A two-group t-test was carried out to compare all variables except patient satisfaction, which was compared using the Mann-Whitney U-test; p < 0.05 was considered significant. RESULTS: Twenty patients were included in each group. At 4 weeks postoperatively, the VSS score (p = 0.748) and cranioauricular distance (p = 0.647) showed no significant differences between the groups. At 24 weeks postoperatively, the mean VSS scores were 4.85 ± 1.46 and 6.25 ± 1.74 (p = 0.009), the mean cranioauricular distances were 15.80 ± 1.82 mm and 13.95 ± 1.93 mm (p = 0.004), and the patient satisfaction scores were 4.5 ± 0.51 and 3.7 ± 0.47 (p < 0.001) in the experimental group and the control group, respectively, all showing significant differences. Two patients in each group exhibited skin irritation or skin ulcers, which resolved after 6 months of follow-up. CONCLUSION: The application of 3D-printed ear splints provides better inhibition of scar contracture, better maintenance of ear projection and higher patient satisfaction than conventional ear splints following ear elevation surgery in microtia patients. Therefore, 3D-printed ear splints should be preferred over conventional ear splints whenever possible.


Assuntos
Microtia Congênita/cirurgia , Procedimentos Cirúrgicos Reconstrutivos , Fáscia , Humanos , Satisfação do Paciente , Contenções , Resultado do Tratamento
20.
Plast Reconstr Surg ; 146(1): 105-126, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32590652

RESUMO

BACKGROUND: Nonsurgical management of de Quervain disease relies mainly on the use of oral nonsteroidal antiinflammatory drug administration, splint therapy, and corticosteroid injections. Although the latter is most effective, with documented success rates of 61 to 83 percent, there exists no clear consensus pertaining to conservative treatment protocols conferring the best outcomes. This article reports on all present conservative treatment modalities in use for the management of de Quervain disease and highlights specific treatment- and patient-related factors associated with the best outcomes. METHODS: A systematic search was performed using the PubMed database using appropriate search terms; two independent reviewers evaluated retrieved articles using strict inclusion and exclusion criteria. RESULTS: A total of 66 articles met the inclusion criteria for review, consisting of 22 articles reporting on outcomes following a single conservative treatment modality, eight articles reporting on combined treatment approaches, 13 articles directly comparing different conservative treatment regimens, and 23 case reports. CONCLUSIONS: A multimodal approach using splint therapy and corticosteroid injections appears to be more beneficial than either used in isolation. Although there exists some evidence showing that multipoint injection techniques and multiple injections before surgical referral may provide benefit over a single point injection technique and a single injection before surgery, corticosteroid use is not benign and should thus be performed with caution. Ultrasound was proven valuable in the visualization of an intercompartmental septum, and ultrasound-guided injections were shown to both be more accurate and confer better outcomes. Several prior and concurrent medical conditions may affect conservative treatment outcome. A Level I to II evidence-based treatment protocol is recommended for the optimal nonsurgical management of de Quervain disease.


Assuntos
Tratamento Conservador/métodos , Doença de De Quervain/terapia , Corticosteroides/uso terapêutico , Algoritmos , Anti-Inflamatórios , Terapia Combinada/métodos , Humanos , Contenções
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