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Objective @#To investigate the effect of tension on donor site recovery of modified forearm flaps (closed forearm donor site skin flaps).@*Methods @# From October 2018 to April 2021, 12 patients with oral cancer underwent forearm flap repair at Xuzhou Central Hospital. Handgrip strength and wrist motion were recorded before surgery. During the surgical incision at the donor site of the forearm, the triangular full-thickness skin of the donor site was used to close part of the surgical incision, and the other part of the surgical incision was directly closed and sutured. Tension was measured with a tension meter during the surgical incision at the donor site. Patients were followed up after surgery to observe whether there were postoperative complications such as necrosis and poor healing of donor site wounds, as well as forearm grip strength, wrist range of motion and appearance satisfaction.@* Results@#Among the 12 patients, there was only one elderly patient with postoperative necrosis near the wrist in the donor site skin, and the average tension of the patient was 0.65 kg; the lesion healed after dressing changes. All of the other patients recovered well without postoperative complications. The mean tension of 12 patients was (0.51 ± 0.05) kg. The preoperative and postoperative grip strength of 12 patients was (23.7 ± 10.3) kg and (22.3 ± 10.7) kg, respectively, and the difference was not statistically significant (t=5.872, P<0.001). The mean range of motion of the wrist was (47.6 ± 8.3)°, (45.8 ± 5.8)°; dorsiflexion (54.6 ± 3.2)°, (53.9 ± 2.3)°; radial deviation (37.0 ± 2.3)°, (36.1 ± 2.2)°; ruler deviation (27.1 ± 1.9)°, (26.4 ± 1.3)°, respectively. The t values were 1.64, 1.636, 2.116 and 1.412, and the P values were 0.129, 0.130, 0.058 and 0.186, respectively. All 12 patients were satisfied with the appearance of the donor site of the forearm.@*Conclusion@#When the average tension during suturing is less than 0.5 kg, there is a lower risk of complications at the donor site of the forearm one month after surgery, a lower risk of impaired donor site function, and a greater possibility of patient satisfaction with the appearance of the donor site.
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In order to stimulate the patients' active participation in the process of robot-assisted rehabilitation training of stroke patients, the rehabilitation robots should provide assistant torque to patients according to their rehabilitation needs. This paper proposed an assist-as-needed control strategy for wrist rehabilitation robots. Firstly, the ability evaluation rules were formulated and the patient's ability was evaluated according to the rules. Then the controller was designed. Based on the evaluation results, the controller can calculate the assistant torque needed by the patient to complete the rehabilitation training task and send commands to motor. Finally, the motor is controlled to output the commanded value, which assists the patient to complete the rehabilitation training task. The control strategy was implemented to the wrist function rehabilitation robot, which could achieve the training effect of assist-as-needed and could avoid the surge of assistance torque. In addition, therapists can adjust multiple parameters in the ability evaluation rules online to customize the difficulty of tasks for patients with different rehabilitation status. The method proposed in this paper does not rely on the information from force sensor, which reduces development costs and is easy to implement.
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<p><b>PURPOSE</b>To study the effects of surgical and nonoperative treatment on wrist function in patients with distal radius fracture.</p><p><b>METHODS</b>In total, 97 patients treated for distal radius fracture in the Department of Orthopedic Trauma at the People's Hospital of Peking University from Jan. 2010 to Jun. 2016 were selected for outpatient follow-up, including manipulative reduction and dorsal splint fixation in 24 cases, bivalve cast fixation in 19 cases and open reduction and internal fixation in 54 cases. Evaluation was based on Sartiento's modification of the Gartland and Werley score. Efficacy was assessed with wrist pain as the focus.</p><p><b>RESULTS</b>The wrist function scores of the surgical group were better than nonoperative groups. There was no significant difference in wrist function scores between the dorsal splint group and the bivalve cast group. The ulnar wrist pain incidence had no significant difference in surgical and nonoperative groups. The displace rate in dorsal splint group was higher than other groups.</p><p><b>CONCLUSION</b>The overall effect of surgical treatment of distal radius fracture is better than nonoperative treatment. The ulnar wrist pain incidence has no significant difference in these groups. Dorsal splint fixation is more prone to displace than bivalve cast fixation.</p>
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Objective To study the clinical study of the effect of removing blood stasis and eliminating powder on the recovery of wrist function after distal radius fracture.MethodsA total of 82 patients with distal radius fractures were selected from September 2012 to October 2016.The random number table method was divided into study group and control group.The two groups were given intervention, and the study group (VAS score), the correlation index(swelling time, pain time, fracture healing time), clinical curative effect and the recovery of wrist function were observed and compared with the two groups.ResultsAfter treatment, the VAS scores of the two groups were significantly lower than those before treatment, and the VAS scores of the study group were significantly lower than those of the control group (P<0.05).After the treatment group, the swelling time, pain time (P<0.05).After treatment, the total effective rate was 87.80% higher than that of the control group (68.29%) (P<0.05).After treatment, the two groups were significantly higher than those in the control group (P<0.05), and the wrist function scores of the study group were significantly lower than those of the control group (P<0.05).ConclusionThe combined effect of removing blood stasis and eliminating powder is effective in the treatment of distal radius fractures, which can effectively reduce the pain and reduce the healing time of the fracture and promote the recovery of the wrist function.
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Objective To compare the superiority?inferiority of wrist function recovery of closed reduc?tion and open reduction in the treatment of distal radius fracture. Methods Eighty cases of distal radius frac?tures patients were randomly divided into the study group and the control group. The control group were treated with open reduction and locking plate for treatment,the study group were treated with closed reduction and exter?nal fixation for treatment. The two groups were observed and recorded on operative time,blood loss,fracture heal?ing time, and Gartland?Werleyde determine the efficacy, stability of the distal radioulnar joint, wrist after 6 months of activity,conditions and treatment of complications after patient satisfaction,and compared the results of its analysis. Results The mean operative time and blood loss of the study group patients were significantly less than the control group((42. 3±1. 4) min vs. (63. 4±2. 1) min,(21. 4±11. 2) ml vs. (63. 3±12. 4) ml),the difference was statistically significant(t=52. 874,15. 859,P0. 05) . There were no significant differences in terms of the degree of activity of the wrist joint,such as palm,back,radial deviation,ulnar deviation, rotation, and rotation of two groups 6 months after treatment( P0. 05). The incidence of postoperative complications,total satisfaction of the study group was 7. 5%(3/40),92. 5%(37/40) respectively,of the control group was 27. 5%(11/40),75. 0%(30/40) respectively, the difference was significant(χ2=5. 54,4. 50;P<0. 05) . Conclusion For elderly distal radius fractures,closed reduction and open reduction on Gartland?Werleyde efficacy and stability of the distal radioulnar joint have a cer?tain effect,but closed reduction treatment can significantly reduce operative time and blood loss,it can reduce the incidence of postoperative complications and improve patient satisfaction.
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Objective To observe the clinical efficacy of flexor-extensor alternate electroacupuncture with low-frequency stimulation in improving the wrist-hand function after high spinal cord injury.Method Forty patients with high spinal cord injury were randomized into a treatment group and a control group, 20 cases in each group. The treatment group was intervened by flexor-extensor alternate electroacupuncture with low-frequency stimulation, while the control group was by electroacupuncture. The Lindmark score, MAX and IEMG of sEMG were observed before and after intervention, and the clinical efficacies were compared between the two groups.Result The MAX, IEMG of sEMG and Lindmark scores were significantly changed after the treatment in both groups (P<0.05). The sEMG signal values and Lindmark score of the treatment group were significantly different from that of the control group after the treatment (P<0.05). The total effective rate was 95.0% in the treatment group versus 80.0% in the control group, and the difference was statistically significant (P<0.05).Conclusion Flexor-extensor alternate electroacupuncture with low-frequency stimulation is an effective method in improving the wrist-hand function after high spinal cord injury.
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10.3969/j.issn.2095-4344.2013.25.024