Nonoperative treatment of osteogenesis imperfecta: orthotic and mobility management.
Nonoperative treatment of osteogenesis imperfecta: orthotic and mobility management.
复制标题
成骨不全的非手术治疗：矫形器和活动管理。
DOI：
10.1097/00003086-198109000-00015
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发表时间：
1981
影响因子：
4.2
通讯作者：
E. Bleck
中科院分区：
文献类型：
--
作者：
E. Bleck
骨质疏松症的问题叠加在基本胶原蛋白缺陷的成骨关节炎已接近使用塑料遏制矫形器的下肢，除了发育阶段的移动设备，帮助早期站立和行走。强制早期负重的目的是为下肢骨骼提供应力，以最大限度地减少骨质疏松，防止再骨折和畸形，遏制随后的制动性骨质疏松，从而打破恶性循环。管理目标基于成人的独立需求：日常生活活动和流动性的效率。我们的大多数患者通过使用塑料矫形器、早期负重和电动轮椅达到了这些目标。在随访时，胫骨手动破骨术后使用塑料矫形器，利用流体压缩原理支撑骨折或结构脆弱的骨似乎是成功的。在12例先天性骨发育不良的患儿中，大多数需要进行股骨髓内钉扎。辅助塑料矫形器降低了胫骨和股骨的再骨折率。在12名先天性OI儿童中，有10人在正规教育机构上学，这反映了儿童的社会融合。12名迟发性痴呆儿童表现良好，在日常生活、行动和行动能力方面都完全独立。其中7例采用股骨或胫骨髓内钉固定和塑料矫形器治疗。5名患者无需治疗。
The problem of osteoporosis superimposed on the basic collagen defect of osteogenesis imperfecta has been approached by the use of plastic containment orthoses for the lower limbs, in addition to developmentally staged mobility devices that assist early standing and walking. The purpose of forcing early weight-bearing is to provide stress to the lower limb bones in order to minimize osteoporosis, prevent refracture and deformity, and curb subsequent immobilization osteoporosis, thus breaking a vicious cycle. Management goals are based upon adult needs for independence: efficiency in daily living activities and in mobility. These goals were reached in most of our patients via use of plastic orthoses, early weight-bearing, and electrically powered wheelchairs. Manual osteoclasis of the tibia followed by plastic orthoses utilizing principles of fluid compression to support fractured or structurally weak bones appeared successful at the time of follow-up. Intramedullary rodding of the femur was necessary in most of the 12 children with osteogenesis imperfecta congenita. Supplementary plastic orthoses have reduced the refracture rate in both the tibia and the femur. Social integration of the children was reflected by the fact that among the 12 OI congenita cases, ten were attending regular educational institutions. Twelve OI tarda children fared well, all attaining complete independence in daily living, mobility and ambulation. Seven of this group were treated with intramedullary rodding of the femur or tibia and with plastic orthoses. Five patients required no treatment.