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前腕回内・回外制限の治療にはスプリントの使用が効果的である.われわれは弾性体の捻れを利用する動的装具を使用している.この装具は,矯正力をラチェットギアの操作で段階的に調節可能である.また,ラチェットギアの切り替えで回内と回外,両方の矯正が可能である.この操作は患者自身で行うことができる.本装具で治療した肘関節内骨折術後の3例を検討した.手術から装着までの期間は平均76.6日,装着期間は平均129.0日であった.回内は平均40.0°から平均73.3°で,回外は平均40°から平均83.3°と有意な改善を認めた.合併症の発生も認めず,本装具による回内・回外制限の治療成績は良好であった.
Splint therapy is an effective aid in the treatment of pronation-supination contracture. We use dynamic splints consisting of a wrist cock-up brace, elastic bar, and elbow component. The elastic bar can create a twist force thus providing a rotational torque to the forearm. The rotational torque is adjustable and pronation-supination is changeable;further, patients can perform such adjustments on their own. Using this splint, we treated 3 cases of pronation-supination contracture caused by elbow articular fracture. Mean duration of splint therapy was 129.0 days. The mean day of starting splint therapy after the operation was 76.6 days. Before splint therapy, mean angles of pronation and supination were both 40.0°. After splint therapy, mean pronation and supination angles both improved significantly to 73.3° and 83.3°, respectively. No complications were identified. This kind of a dynamic splint is useful in treating pronation-supination contracture.
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