桡骨远端解剖型纸质支架夹板的设计及人体贴合研究

Development and Body Fit Test of the Anatomical Paper Splint of Distal Radius

目的：研制符合人体解剖特点的桡骨远端解剖型纸质支架夹板，以规范夹板塑形及使用，便于临床操作；并通过观察桡骨远端解剖型纸质支架夹板与肢体贴合情况，评价其优势。方法选取2014年9月—2015年3月南京中医药大学无锡附属医院体检中心体检健康的志愿者90例，根据身高将其分为 A 组（＞175 cm）、B 组（165~175 cm）、C 组（＜165 cm），每组30例。制作研究对象前臂及腕部掌屈尺偏位聚酯绷带模型并进行 CT 扫描，借助Mimics 软件获得数字化三维重建模型，测量模型长宽度、周径、曲率、掌倾角、尺偏角等相关技术参数，以此作为大、中、小3种型号桡骨远端解剖型纸质支架夹板外形参数。选取2015年5—7月南京中医药大学无锡附属医院体检中心体检健康的成年志愿者30例，根据身高将其分为 a 组（＞175 cm）、b 组（165~175 cm）、c 组（＜165 cm），每组10例。a 组使用大号夹板、b 组使用中号夹板、c 组使用小号夹板固定1周，观察夹板长宽度、骨突、鱼际压迫情况及与肢体贴合情况等。结果成功获取了志愿者前臂及腕部外形的数字化三维模型，测量分析后依次确定了大、中、小3种型号桡骨远端解剖型纸质支架夹板的长宽度、曲率、骨突位置、掌屈角、尺偏角及掌、桡侧夹板的大鱼际曲率，尺侧夹板的小鱼际曲率等技术参数。30例贴合试验中仅有5例皮肤与夹板间存在间隙，经小于5＆#176;的塑形后均贴合满意；固定后不影响志愿者肘及掌指关节屈伸活动，夹板间间距合适，骨突及鱼际处无压迫感；1周后解除夹板未见局部皮肤压迹。结论桡骨远端解剖型纸质支架夹板具有符合局部解剖、无需过多塑形、临床使用方便等特点，临床治疗应用前景广阔。

Objective To develop an anatomical paper splint of distal radius which fits in with human anatomy characteristics,thus the moulding and application of the splint can be standardized,and the clinical operations can be easily done. To evaluate the advantages by observing whether the splint fit the body well. Methods During September 2014 to March 2015,90 healthy volunteers from Center of Health Examination of Wuxi Affiliated Hospital,Nanjing University of Chinese Medicine were divided into 3 groups（30 in each group）according to their heights：group A（ 〉 175 cm）,group B（165- 175 cm）and group C（ 〈 165 cm）. The wrist flexion and ulnar position polyester bandage model of the volunteers＇ forearms and wrist was made and scanned by CT. The 3D digital reconstruction model was obtained by Mimics. The length,width, perimeter,curvature,palmar tilt and ulnar inclination of the model were measured,and these parameters were used as the profile parameters of the anatomical paper splint of distal radius with 3 different types（ L,M,S）. During May 2015 to July 2015,30 healthy volunteers from Center of Health Examination of Wuxi Affiliated Hospital,Nanjing University of Chinese Medicine,were divided into 3 groups（10 in each group）according to their heights：group a（ 〉 175 cm）,group b（165 -175 cm）,and group c（ 〈 165 cm）. Cases in group a,b and c used splint type L,M and S respectively for 1 week,the length and width of the splint were measured,the oppressive situation of the apophysis and the thenar was observed,and the fit condition was observed. Results The digital 3D models of appearances of the volunteers＇ forearms and wrists were obtained. The＆amp technical parameters of the 3 types（L,M,S）of the splints,including the length,the width,the curvature,the position of the apophysis,palmar flexion and ulnar deviation,the thenar curvature of palm and radial side splint,and the hypothenar curvature of ulnar splint were determined. Among 30 cases who participate in fitting test,only 5 had clearance problem between skin and splints,and got satisfied effect after a proper adjustment less than 5＆#176;. The flexion and extension of the elbow joint and the metacarpophalangeal joints were not affected. The space between splints was appropriate,and no feeling of pressure existed around the apophysis and the thenar. There was no partial skin pressure mark when the splints were moved away after one week. Conclusion The anatomical paper splint of distal radius fits in with topography,and don＇t need an excess of moulding. It is easy to use and has a wide clinical application prospect.