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Based on the pathogenesis of “tendon off-position and joint subluxation”， combined with modern ana-tomy and biomechanics， the characteristic manifestations of “tendon off-position” and “joint subluxation” of the knee and the intrinsic connection between them are clarified. Through sorting out the relationship between “tendon off-position and joint subluxation” and knee osteoarthritis （KOA） in modern research， it is believed that “tendon off-position and joint subluxation” is the key mechanism for the occurrence and development of KOA， and accordingly， it is proposed to take the diet as the guide， use bone manipulation for external diagnosis and treatment， use traditional Chinese medicine decoction for internal treatment， and use Daoyin exercise throughout the whole process as the strategy for KOA's comprehensive traditional Chinese medicine treatment to improve the clinical effectiveness.
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According to Chinese medicine, the atlantoaxial joint is a composite joint composed of tendons and bones, and the stability of the joint depends on the 'tendon-bone balance' involving tendons, ligaments, atlas and axis. Multiple causes of 'tendon off-position, joint subluxation' will lead to joint 'tendon-bone imbalance', which will evolve into atlantoaxial subluxation (AAS), endangering human health. Chinese therapeutic massage (tuina) is a very effective treatment for AAS in adults, but conventional manipulations are prone to ineffectiveness or accidents due to neglect of the causal relationship of the 'tendon-bone imbalance' and inappropriate manipulations. Compared with conventional manipulations, the rational choice of modified manipulations under the guidance of 'tendon-bone balance' theory is more effective and less risky, and more worthy of clinical promotion. From the 'tendon-bone balance' theory, we considered the shortcomings of conventional manipulations, and introduced several modified manipulations that have their own strengths in 'tendon smoothing' and 'bone setting', in order to provide new ideas for treatment of AAS in adults.
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[Objective] Sorting and summing up Professor ZHANG 's clinical experience in the diagnosis and treatment of atlanto-axial joint subluxation, to develop the thought of clinical diagnosis and treatment of the disease. [Methods]Via studying with professor ZHANG, and collectting some cases,consulting the related literature and data.Finally, discuss and summarize it. [Results] Diagnosis found and appliedFour tenderness(Below the foramen magnum, trapezius muscle and at the junction of the skull,fengchi point,wangu point).Method combined with primary symptom and signs, X-ray. Treatment, application of error correction manipulation, light effect;And with local acupuncture point injection, menstruation invigorates the circulation of reinforcement. [Conclusion] Professor ZHANG's method of diagnosis and treatment of atlanto-axial joint subluxation is unique,clear, simple, has obvious curative effect, worth clinical application and promotion.
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Objective To explore the digital tomosynthesis(DTS)technology application value in children with atlanto-axial joint subluxation inspection.Methods 30 children with torticollis after injury,head and neck activities obstacles or local pain were selected.The consent of patient and family was obtained.At the same time the atlanto-axial joint open mouth,cervical lateral radiographies and DTS scanning were performed,two imaging quality and the diagnosis were compared.Results In all 30 cases,excellent imaging rate was 90% (27/30)on DTS and 53% (1 6/30)on DR respectively.On DTS atlanto-axial sublution were found in 22 cases but on DR atlanto-axial sublution were diagnosed in only 12 cases,suspicious subluxation in 4 cases,and misdiagnosis in 6 cases.Conclusion For diagnosis of atlanto-axial joint subluxation in children,DTS can obtain high quality images,clearly display anatomic structures and pathological morphology of atlanto-axial joint.
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Grisel's syndrome, defined as the atlanto-axial joint subluxation not associated with a trauma or bone disease, is a rare complication following operative procedure and/or infections of the upper aerodigestive tract. Pathogenetically, it may occur in association with any condition that results in hyperemia and pathological relaxation of the transverse ligament of the atlanto-axial joint. When an inflammation heals, Grisel's syndrome can probably result in a fixation in the rotated position. It is diagnosed by physical and radiological findings. Early management, consisting of cervical immobilization and medical treatment, is considered a key factor for satisfactory outcome. Inappropriate treatment can result in a catastrophic consequence. Recently, we experienced a case of Grisel's syndrome following tonsillectomy in a patient with left palatine tonsillar cancer with preoperative radiotherapy. We report this case with a literature review.
Asunto(s)
Humanos , Articulación Atlantoaxoidea , Enfermedades Óseas , Hiperemia , Inmovilización , Inflamación , Ligamentos , Radioterapia , Relajación , Procedimientos Quirúrgicos Operativos , Neoplasias Tonsilares , TonsilectomíaRESUMEN
@#ObjectiveTo observe the effects of acupuncture combined with massage on shoulder subluxation and motor function recovery of the upper extremities in patients with hemiplegia after stroke.Methods60 hemiplegic patients were randomly divided into two groups for treatment with acupuncture cooperates with massage or usual rehabilition, respectively. The recovery of the patient's shoulder subluxation and movement function of upper extremities were evaluated 2 months after treatment. ResultsThe shoulder subluxation and movement function of the upper extremities were improved after treatment with both therapies (P<0.01), and acupuncture cooperates with massage showed better effect (P<0.01). ConclusionAcupuncture cooperates with massage can facilitate the recovery of shoulder subluxation and motor function of the upper extremities after hemiplegia.