|
О сайте:
|
The Effect of a Wrist Brace on Injury Patterns
</p>
<p>
We compared patterns of bony and ligamentous injury with distal radial fractures
in braced and unbraced wrists using 20 paired fresh cadaveric upper extremi ties. A
commercially available wrist brace was placed on one wrist in each pair. Specimens
were then placed in a fast-loading gravity-driven device and subjected to loads
averaging 16 kg from an average height of 78 cm. Postfracture radiographs were
obtained, the spec imens were dissected, and fracture patterns and liga mentous
integrity were assessed. The following frac ture types were produced: distal radial
fractures (eight unbraced, seven braced) and intraarticular (seven un braced, four
braced). Radiographically, seven un braced wrists demonstrated carpal bone fracture
and one braced wrist demonstrated carpal fractures. Eight unbraced and three braced
wrists sustained carpal intrinsic ligament injuries, four unbraced and one braced
wrists demonstrated extrinsic ligament injuries. More capsular tears occurred in the
unbraced group (N = 8) than in the braced group (N = 1). This model demonstrated a
difference in the patterns of injury in unbraced and braced wrists subjected to the
same mechanical conditions, which suggests that use of a wrist brace may alter
patterns of wrist injury.
</p>
<p>
<br/>
</p>
<p>
Braces and splints can be useful for acute injuries, chronic conditions, and the
prevention of injury. There is good evidence to support the use of some braces and
splints; others are used because of subjective reports from patients, relatively low
cost, and few adverse effects, despite limited data on their effectiveness. The
unloader (valgus)<a href="http://www.jjsports-medical.com/knee-support/knee-brace/"
target="_self"> knee brace </a>is recommended for pain reduction in patients with
osteoarthritis of the medial compartment of the knee. Use of the patellar brace for
patellofemoral pain syndrome is neither recommended nor discouraged because good
evidence for its effectiveness is lacking. A knee immobilizer may be used for a
limited number of acute traumatic knee injuries. Functional ankle braces are
recommended rather than immobilization for the treatment of acute ankle sprains, and
semirigid ankle braces decrease the risk of future ankle sprains in patients with a
history of ankle sprain. A neutral wrist splint worn full-time improves symptoms of
carpal tunnel syndrome. Close follow-up after bracing or splinting is essential to
ensure proper fit and use. Am Fam Physician 2007;75:342–8. Copyright © 2007 American
Academy of Family Physicians.)
</p>
<p>
<br/>
</p>
<p>
Family physicians often must make decisions regarding the use of braces or splints
in the management of musculoskeletal disorders. Bracing can be useful for acute
injuries, and also for chronic conditions and in the prevention of injury. The purpose
of braces and splints is to improve physical function, slow disease progression, and
diminish pain. They can be used to immobilize an unstable joint or fracture, to unload
a portion of a joint and improve pain and function, to eliminate range of motion in
one direction, or to modify range of motion in one or more directions. They do not
replace a good rehabilitative program, and the entire spectrum of treatment options
should be explored and used as needed.
</p>
<p>
<br/>
</p>
<p>
Accurate diagnosis of the injury is important in determining whether a brace or
splint is indicated. Generally, splints are for short-term use. Excessive, continuous
use of a brace or splint can lead to chronic pain and stiffness of a joint or to
muscle weakness. However, long-term use of some braces, such as a <a
href="http://www.jjsports-medical.com/knee-support/" target="_self">knee support,</a>
can help prevent progression of pain attributable to osteoarthritis of the knee.
</p>
<p>
<br/>
</p>
<p>
Given the limited evidence on the use of braces and splints, it is particularly
important to use a patient-centered approach, with consideration for individual
patient's expectations and concerns and an understanding of the nature of their
activity. For example, for high school and collegiate athletes, there are specific
rules on the types of protective equipment, splints, and braces that may be worn
during competition.1 Close follow-up after bracing or splinting is essential to ensure
proper fit and use.
</p>
<p>
|