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[PMID]:29182002
[Au] Autor:Richards T; Clement R; Russell I; Newington D
[Ad] Endereço:Department of Orthopaedic Hand Surgery, Morriston Hospital , Swansea , UK.
[Ti] Título:Acute hand injury splinting - the good, the bad and the ugly.
[So] Source:Ann R Coll Surg Engl;100(2):92-96, 2018 Feb.
[Is] ISSN:1478-7083
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Injuries to the hand comprise 20% of all emergency department attendances, with an estimated annual treatment cost of over £100 million in the UK. The initial assessment and management of hand injuries is usually undertaken by junior staff, many of whom have little or no training or experience in splinting hand fractures. In the Department of Orthopaedic Hand Surgery, Morriston Hospital, we regularly observe patients presenting to the specialist hand fracture clinics having had initial management that shows no appreciation for the treatment objectives or the safe positions for splinting. This article aims to provide guidance for frontline staff on the management of hand fractures, with particular emphasis on the appropriate nonoperative care to avoid any unnecessary morbidity.
[Mh] Termos MeSH primário: Fixação de Fratura
Fraturas Ósseas/cirurgia
Traumatismos da Mão/cirurgia
Contenções
[Mh] Termos MeSH secundário: Fixação de Fratura/instrumentação
Fixação de Fratura/métodos
Fraturas Ósseas/diagnóstico por imagem
Traumatismos da Mão/diagnóstico por imagem
Seres Humanos
Contenções/efeitos adversos
Contenções/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE
[do] DOI:10.1308/rcsann.2017.0195


  2 / 7320 MEDLINE  
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[PMID]:29310416
[Au] Autor:Tomori Y; Sawaizumi T; Mitsuhiko N; Takai S
[Ti] Título:Medium-term outcome of closed radial wedge osteotomy of the distal radius for Preiser disease with concomitant Kienböck disease: Two case reports and a literature review.
[So] Source:Medicine (Baltimore);96(48):e9002, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Idiopathic avascular necrosis of the scaphoid or lunate bone are known as Preiser disease and Kienböck disease, respectively. Although there are reports of avascular necrosis involving more than one carpal bone, concurrent idiopathic avascular necrosis of the scaphoid and lunate bones is rare, with only five cases reported in the English literature (including the two herein). Although the optimum treatment for Preiser disease with concomitant Kienböck disease has not been established, our cases underwent closed radial wedge osteotomy based on the evidence of satisfactory outcomes for treating Kienböck disease. We report the medium-term results of closed radial wedge osteotomy of the distal radius in two cases of Preiser disease with concomitant Kienböck disease. PATIENT CONCERNS: We presented two patients with concomitant Preiser and Kienböck diseases. Although both smoked cigarettes, neither had any other risk factors; there was no history of trauma, although both women had jobs that required relatively heavy or repetitive manual labor. DIAGNOSES: Two patients were diagnosed by radiographs and magnetic resonance imaging of the wrists. INTERVENTIONS: A non-surgical strategy of splint immobilization and analgesia was not effective, and surgery was ultimately required. OUTCOMES: Satisfactory medium-term results were achieved with closed radial wedge osteotomy of the distal radius in both cases. Although there was imaging evidence of progression of dorsal intercalated segmental instability deformity, neither of the patients was symptomatic and both declined salvage surgery. LESSONS: We compare our cases and treatment strategy with others reported in the literature. Our cases suggest that closed radial wedge osteotomy of the distal radius is a safe and relatively straightforward means of treating patients with this rare combination of wrist disorders, and appears to obviate the need for more extensive salvage procedures.
[Mh] Termos MeSH primário: Osteonecrose/cirurgia
Osteotomia
Rádio (Anatomia)/cirurgia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Meia-Idade
Osteonecrose/diagnóstico por imagem
Osteonecrose/tratamento farmacológico
Rádio (Anatomia)/diagnóstico por imagem
Contenções
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009002


  3 / 7320 MEDLINE  
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[PMID]:28984769
[Au] Autor:Chen W; Liu X; Pu F; Yang Y; Wang L; Liu H; Fan Y
[Ad] Endereço:aKey Laboratory of Rehabilitation Technical Aids, Ministry of Civil Affair, School of Biological Science and Medical Engineering, Beihang University bState Key Laboratory of Virtual Reality Technology and Systems, Beihang University cNational Research Center for Rehabilitation Technical Aids dRokab Pedorthic Center, Beijing, P.R. China.
[Ti] Título:Conservative treatment for equinus deformity in children with cerebral palsy using an adjustable splint-assisted ankle-foot orthosis.
[So] Source:Medicine (Baltimore);96(40):e8186, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: A novel splint, the assisting ankle-foot orthoses (AFO), was developed to provide adjustable sustained stretching to improve conservative treatment for equinus deformities in children with cerebral palsy (CP). The treatment effect was validated by follow-up visits. METHODS: This study involved subjects between 2 and 12 years old, including 28 CP children treated with splint-assisted AFO correction, 30 CP children treated with static AFO correction, and 30 normal children with typical development (TD). Quantitative pedobarographic measurements were taken to evaluate the effect of splint-assisted AFO correction. The heel/forefoot ratio was introduced to indicate the degree of the equinus deformity during treatment. RESULTS: The results showed that the heel/forefoot ratios were 1.41 ±â€Š0.26 for the TD children; 0.65 ±â€Š0.41, 1.02 ±â€Š0.44, and 1.24 ±â€Š0.51 for the splint-assisted AFO correction before and after 6-month and 12-month treatments; 0.59 ±â€Š0.37, 0.67 ±â€Š0.44, and 0.66 ±â€Š0.42 for the static AFO correction before and after 6-month and 12-month treatments. CONCLUSIONS: This study suggests that correction with the adjustable splint-assisted AFO is an effective treatment for equinus deformity in CP Children.
[Mh] Termos MeSH primário: Paralisia Cerebral/complicações
Tratamento Conservador/instrumentação
Pé Equino/terapia
Órtoses do Pé
Contenções
[Mh] Termos MeSH secundário: Tornozelo/fisiopatologia
Estudos de Casos e Controles
Criança
Pré-Escolar
Tratamento Conservador/métodos
Pé Equino/etiologia
Pé Equino/fisiopatologia
Desenho de Equipamento
Feminino
/fisiopatologia
Calcanhar/fisiopatologia
Seres Humanos
Masculino
Estudos Prospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171007
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008186


  4 / 7320 MEDLINE  
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[PMID]:28872995
[Au] Autor:Chatzidimitriou K; Lygidakis NN; Lygidakis NA
[Ti] Título:Eva Vacuum-Formed Alternative Splinting of Alveolar Fractures in Primary Dentition: A Case Report.
[So] Source:J Clin Pediatr Dent;41(5):327-331, 2017.
[Is] ISSN:1053-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Alveolar fractures treatment includes repositioning of displaced segments and splinting. In children, splinting procedures may occasionally present clinical problems resulting from fewer teeth available for splinting or presence of occlusal disturbances. An alternative clinical approach for splinting in alveolar fractures of primary dentition is described. CLINICAL CASE: A 4.5-year-old girl was referred to our clinic 8 hours after a fall accident. Clinical examination revealed mandibular alveolar process segmental fracture in the right canine area with frontal dislodgement of the labial cortical bone resulting to occluding inability. The area was anaesthetized, cleaned and the dislodged bone was manually repositioned, followed by an EVA copolymer splint for fixation as a result of patient's deep bite impeding regular wire-composite splint. The cap splint that was fabricated on a cast made after an alginate impression, was set on the mandibular dentition and immobilized in the primary molars with acid-etch adhesive and flowable resin composite. Following splint removal after 4 weeks and follow-up visits, successful healing was observed clinically and radiographically with no pathological signs and symptoms. CONCLUSION: The described alternative splinting method in alveolar fractures of primary dentition is a valuable clinical tool for peediatric dentists, easily accepted by children in cases where regular splinting methods cannot be used.
[Mh] Termos MeSH primário: Processo Alveolar/lesões
Contenções
Fraturas dos Dentes/terapia
Vácuo
[Mh] Termos MeSH secundário: Pré-Escolar
Desenho de Equipamento
Feminino
Seres Humanos
Dente Decíduo
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:D
[Da] Data de entrada para processamento:170906
[St] Status:MEDLINE
[do] DOI:10.17796/1053-4628-41.5.327


  5 / 7320 MEDLINE  
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[PMID]:28819519
[Au] Autor:El Kadi K; Benabid M; Saliou S; El Assil O; Marzouki A; Lahrach K; Boutayeb F
[Ad] Endereço:Department of Orthopedic Surgery (A), UH Hassan II, Fes, Morocco.
[Ti] Título:Simultaneous ipsilateral fractures of distal and proximal ends of the radius.
[So] Source:Pan Afr Med J;27:98, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:eng
[Ab] Resumo:We treated a patient with a rare combination of ipsilateral fractures of the distal and proximal ends of the radius. A man aged 42 years had simultaneous fractures of the distal and proximal ends of the radius (radial neck) following a roadside accident. The distal end fracture of the radius was treated with surgical reduction and T-plate volar fixation, and the undisplaced radial neck fracture was treated by an above elbow splintage for 2 weeks. The elbow mobilization was started at 2 weeks. The distal radius was protected for another 4 weeks in a below elbow functional brace. Ipsilateral proximal and distal radial fracture is an uncommon injury pattern. The series illustrates a number of problems associated with this combination. Firstly, one should be aware of this rare injury pattern and there should be greater emphasis on clinical examination of elbow in cases of wrist injuries and vice versa. Once diagnosed, one faces the dilemma of appropriate management in these cases. The appropriate management will depend on the injury characteristics including the age of the patient and the fracture pattern. One should try to preserve the radial head to prevent a possible proximal radial migration especially in younger patients.
[Mh] Termos MeSH primário: Fixação Interna de Fraturas/métodos
Fraturas do Rádio/patologia
Rádio (Anatomia)/lesões
[Mh] Termos MeSH secundário: Acidentes de Trânsito
Adulto
Braquetes
Articulação do Cotovelo
Seres Humanos
Masculino
Fraturas do Rádio/cirurgia
Contenções
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170819
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.27.98.3504


  6 / 7320 MEDLINE  
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[PMID]:28660834
[Au] Autor:Prasetyono T; Caroline I
[Ad] Endereço:Division of Plastic Surgery, Department of Surgery, Cipto Mangunkusumo Hospital, Jakarta , Indonesia.
[Ti] Título:The role of two-sided splinting for recalcitrant paediatric post-burn hand flexion contracture: a case report.
[So] Source:Ann R Coll Surg Engl;99(6):e185-e187, 2017 Jul.
[Is] ISSN:1478-7083
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:A 2-year-old boy presented to the plastic and reconstructive surgery outpatient clinic with bilateral post-burn hand flexion contracture. The contracture had been released twice elsewhere. The third surgical repair on one hand at a time was conducted by the author (TOHP). However, inadeq.uate compliance to the postoperative splinting and exercise led to the recurrence of the contracture in the following year. A customised two-sided splint was therefore created to ensure proper placement and compliance. Reinforcement to the parents to encourage the boy to practise active exercise on demand was also an integral part of the management. Good functional and cosmetic outcome were presented at 1-year follow-up. This case highlights the value of a two-sided splint for the management of post-burn hand flexion contracture in children whose compliance is inevitably cannot be guaranteed.
[Mh] Termos MeSH primário: Queimaduras
Contratura
Traumatismos da Mão
Procedimentos Cirúrgicos Reconstrutivos
Contenções
[Mh] Termos MeSH secundário: Queimaduras/patologia
Queimaduras/reabilitação
Queimaduras/cirurgia
Pré-Escolar
Contratura/patologia
Contratura/prevenção & controle
Contratura/reabilitação
Contratura/cirurgia
Mãos/patologia
Mãos/cirurgia
Traumatismos da Mão/patologia
Traumatismos da Mão/reabilitação
Traumatismos da Mão/cirurgia
Seres Humanos
Masculino
Procedimentos Cirúrgicos Reconstrutivos/instrumentação
Procedimentos Cirúrgicos Reconstrutivos/métodos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170630
[St] Status:MEDLINE
[do] DOI:10.1308/rcsann.2017.0103


  7 / 7320 MEDLINE  
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[PMID]:28654603
[Au] Autor:Economides JM; Baker SB
[Ad] Endereço:Washington, D.C. From the Department of Plastic Surgery, MedStar-Georgetown University Hospital.
[Ti] Título:Discussion: A Morphometric Study of the Newborn Ear and an Analysis of Factors Related to Congenital Auricular Deformities.
[So] Source:Plast Reconstr Surg;140(1):156-157, 2017 07.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Orelha Externa/anormalidades
Contenções
[Mh] Termos MeSH secundário: Deformidades Adquiridas da Orelha
Seres Humanos
Recém-Nascido
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170810
[Lr] Data última revisão:
170810
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170628
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003488


  8 / 7320 MEDLINE  
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[PMID]:28511813
[Au] Autor:Tolkien Z; Potter S; Burr N; Gardiner MD; Blazeby JM; Jain A; Henderson J
[Ad] Endereço:Bristol Centre for Surgical Research, School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Clifton, Bristol, BS8 2PS, UK.
[Ti] Título:Conservative management of mallet injuries: A national survey of current practice in the UK.
[So] Source:J Plast Reconstr Aesthet Surg;70(7):901-907, 2017 Jul.
[Is] ISSN:1878-0539
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Mallet injuries are common and usually treated conservatively. Various systematic reviews have found a lack of evidence regarding the best management, and it is unclear whether this uncertainty is reflected in current UK practice. METHODS: An online survey was developed to determine the current practice for the conservative treatment of mallet injury among specialist hand clinicians in the UK, including physiotherapists, occupational therapists and surgeons. Clinician's views of study outcome selection were also explored to improve future trials. RESULTS: In total, 336 professionals completed the survey. Inconsistency in overall practice was observed in splint type choice, time to discharge to GP, and assessment of adherence. Greater consistency was observed for recommended duration of continuous immobilisation. Bony injuries were most commonly splinted for 6 weeks (n = 228, 78%) and soft tissue injuries for either 8 weeks (n = 172, 56%) or 6 weeks (n = 119, 39%). Post-immobilisation splinting was frequently recommended, but duration varied between 2 and 10 weeks. The outcome rated as most important by all clinicians was patient satisfaction. DISCUSSION: There is overall variation in the current UK conservative management of mallet injuries, and the development of a standardised, evidence-based protocol is required. Clinicians' opinions may be used to develop a core set of outcome measures, which will improve standardisation and comparability of future trials.
[Mh] Termos MeSH primário: Tratamento Conservador
Traumatismos dos Dedos/terapia
Padrões de Prática Médica
Polegar/lesões
[Mh] Termos MeSH secundário: Seres Humanos
Imobilização
Terapia Ocupacional/métodos
Ortopedia/métodos
Cooperação do Paciente
Alta do Paciente
Fisioterapia/métodos
Contenções
Cirurgia Plástica/métodos
Inquéritos e Questionários
Fatores de Tempo
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170823
[Lr] Data última revisão:
170823
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170518
[St] Status:MEDLINE


  9 / 7320 MEDLINE  
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[PMID]:28489447
[Au] Autor:Prakash R; Ong E; Brown D; Hunter A
[Ad] Endereço:Foundation Year 1 Doctor, Department of Trauma and Orthopaedics, Royal Free Hospital, London NW3 2QG.
[Ti] Título:Patient-initiated splintage of a mallet finger injury avoids unnecessary complications.
[So] Source:Br J Hosp Med (Lond);78(5):296-297, 2017 May 02.
[Is] ISSN:1750-8460
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Traumatismos dos Dedos/terapia
Autocuidado
Contenções
Traumatismos dos Tendões/terapia
[Mh] Termos MeSH secundário: Adulto
Seres Humanos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170717
[Lr] Data última revisão:
170717
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170511
[St] Status:MEDLINE
[do] DOI:10.12968/hmed.2017.78.5.296


  10 / 7320 MEDLINE  
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[PMID]:28445374
[Au] Autor:Hindin DI; Muetterties CE; Mehta C; Boukovalas S; Lee JC; Bradley JP
[Ad] Endereço:Philadelphia, Pa.; and Los Angeles, Calif. From the Division of Plastic and Reconstructive Surgery, Temple University; and the Division of Plastic and Reconstructive Surgery, University of California, Los Angeles.
[Ti] Título:Treatment of Isolated Zygomatic Arch Fracture: Improved Outcomes with External Splinting.
[So] Source:Plast Reconstr Surg;139(5):1162e-1171e, 2017 May.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The various approaches to reduction and fixation of isolated displaced zygomatic arch fractures have not been well studied. The authors compared established treatment methods for zygomatic arch fractures for both aesthetic and functional outcomes. METHODS: Consecutive patients with isolated zygomatic arch fractures with a minimum of 6 months' follow-up were studied in five groups: group 1, intraoral approach (no fixation); group 2, temporal approach (no fixation); group 3, coronal flap plate fixation; group 4, external splint fixation; and group 5, no surgery. Perioperative complications, facial contour symmetry (aesthetic outcome), improvement in mouth opening (functional outcome), and reoperations were compared. RESULTS: Patients undergoing external splint fixation had no perioperative complications. Coronal flap plate fixation had the highest rate of perioperative complications (46 percent), with facial nerve injury (4 percent), hematoma (8 percent), and persistent hyperesthesia (8 percent). Reoperations (fat grafting or bony reconstruction) were highest with coronal flap plate fixation (23 percent) and the temporal approach (7.7 percent); external splint fixation and the intraoral approach required no reinterventions. Patients treated with external splint fixation had the largest improvement in mean interincisor mouth opening. Mean postoperative interincisor opening in decreasing order was as follows: external splint fixation (51.6 mm), coronal flap plate fixation (47.1 mm), no surgery (39.8 mm), intraoral approach (39.6 mm), and temporal approach (38.9 mm). The highest volumetric symmetry was seen in external splint fixation (97.9 percent), followed by coronal flap plate fixation (94 percent), temporal approach (76.2 percent), intraoral approach (73 percent), and no surgery (68.3 percent). CONCLUSION: For isolated zygomatic arch fracture, patients undergoing external splint fixation had the lowest risk of perioperative complications and the greatest improvement in functional and aesthetic outcomes compared with the intraoral approach (no fixation), the temporal approach (no fixation), coronal flap plate fixation, and no surgery. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
[Mh] Termos MeSH primário: Placas Ósseas
Fixadores Externos
Fixação de Fratura/instrumentação
Contenções
Zigoma/lesões
[Mh] Termos MeSH secundário: Adulto
Feminino
Pesquisas sobre Serviços de Saúde
Seres Humanos
Masculino
Estudos Prospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170427
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003281



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