踝足康复牵引器对脑外伤偏瘫患者踝关节的影响

目的:探讨踝足康复牵引器对脑外伤偏瘫患者踝关节活动范围的影响。方法:脑外伤偏瘫患者66例分为观察组34例和对照组32例,2组均采用常规康复训练,同时对照组配合徒手牵拉踝关节治疗;观察组配合踝足康复牵引器治疗。结果:治疗8周后,2组患者的踝关节活动范围、下肢运动功能及ADL能力均较治疗前明显提高(P<0.05);且观察组明显高于对照组(P<0.05)。结论:踝足康复牵引器对增加脑外伤偏瘫患者踝关节活动范围,改善踝关节挛缩,提高ADL能力均有积极的促进作用。

踝足康复牵引器设计原理及使用方法

目的简化制作、操作过程,为临床提供一种实用有效的康复牵引器。方法根据患者不同病情,因人而异选取木板,包裹海绵皮革,在木板上安装吊环,合页连接,螺丝固定,同时安装踝关节固定带。结果踝足康复牵引器节省人力、物力,操作简单,使用方便,切实有效。结论踝足康复牵引器设计合理,有效预防和治疗踝关节挛缩,抑制异常肌张力及跖屈内翻畸形,缩短了患者的康复进程,提高了患者日常活动能力。

外踝外侧入路与后侧入路对外踝骨折疗效的影响

踝关节由胫骨远端、腓骨远端和距骨体所组成,行走时踝关节跖屈位距骨体与踝穴活动间隙增大极易发生外踝骨折[1]。由于发病原因多由外力或脚踝扭伤所致,多数踝关节骨折伴随有关节软骨的损伤,导致关节处肌肉疼痛、活动受限[2]。目前常采用手术治疗,但手术治疗前需对踝关节进行复位,使关节恢复正常的解剖结构。手术入路主要有外踝外侧入路和后侧入路两种,外侧入路具有操作方便、骨折部位易显现的特点,但由于外侧腓骨端覆盖组织较少,会存在手术占位大、切口愈合不良等并发症;而后侧入路则可通过腓骨后侧放置钢板固定骨折,防止远端骨折块发生位移,具有较好的解剖学优点[3]。本研究探讨外踝外侧入路与后侧入路对外踝骨折的临床疗效,现报道如下。

The biomechanical study of lower limb during human walking

The coordinates of the marked points of joints and the changes of foot force in the human walk motion are obtained with systems of motion image acquisition and force measuring.The effects of kinematics and dynamics on the human lower limb in different loads(0,10,20,30 kg) and walking speeds(0.8,1.3,1.7 m/s) have been investigated using the human dynamics model,.The results were as follows.First,with the increasing load,the dorsiflexion angle of ankle joint increased during the procedure of toe-off,the range of motion of the knee joint decreased,the flexion angle of the hip joint increased,and oppositely,the extension angle of the hip joint decreased.Second,with the increasing speed,the range of motion of the ankle joint,the maximum flexion angle of the knee joint,the flexion angle,extension angle of the hip joint and the range of motion of hip joint increased.Finally,the torque and power of the ankle joint,the knee joint and the hip joint increased with the increasing speed and load.The results can provide an important basis for the mechanism design of lower limb power-assisted exoskeleton.