I-Corps: A Novel Functional Shoulder Brace to Limit Dislocation

创伤性肩关节脱位约占美国人口的1.7%，可导致慢性不稳定、疼痛和活动范围受限。矫形肩支具是肩关节重新稳定的主要治疗方法，也是肩关节手术重建的一种替代姑息性、低成本治疗方法。不断增长的活动人口和老年人口对创新骨科支撑装置提出了很高的要求，这些装置可以提供支撑性肩部支撑，同时能够实现足够的活动范围，以促进恢复运动和休闲活动。开发了一种新型矫形肩支具，可为大多数运动和休闲活动提供主动活动范围，同时限制复发性前脱位风险高的特定活动范围。该支架由柔软透气的上身和肩部包裹物、可调节的压缩带和定制的热成型稳定插入物组成。该器械的初步测试已确认其易于应用、舒适度、限制危险肩关节运动的能力以及功能性肩关节运动的维持。虽然创伤性肩关节脱位最常见于15至29岁的年轻活跃男性，但复发性脱位风险（高达90%）的影响会影响整个人群的累积医疗费用，工资损失和生产力损失。复发性脱位的风险与初次脱位的年龄呈强烈的负相关，老年患者更容易发生肩袖撕裂伴脱位。虽然最初的创伤通常需要诱发脱位，但在常见的运动和工作相关任务中更容易发生再脱位。设计一种功能性支具，限制危险的肩部行为，并支持积极的肩部功能，将广泛影响康复，物理治疗和运动医学领域。减少再脱位的发生率将减少医疗费用，提高工作场所的生产力，并促进更积极的人口。

Traumatic shoulder dislocation occurs in approximately 1.7% of the US population, and can result in chronic instability, pain and limited range of motion. Orthopaedic shoulder braces are a primary treatment method for the re-stabilization of the shoulder, and are an alternative palliative, low-cost treatment method to surgical reconstruction of the shoulder. The growing active and elderly populations are placing a high demand for innovation of orthopaedic bracing devices that can provide supportive shoulder bracing, while enabling sufficient ranges of motion to facilitate the return to sport and leisure activities. A new orthopaedic shoulder brace has been developed that enables active ranges of motion for most sport and leisure activities, while limiting specific ranges of motion that are at high risk of recurrent anterior dislocation. The brace consists of a soft, breathable upper torso and shoulder wrap, adjustable compressive straps, and a custom heat-moldable stabilization insert. Preliminary testing of the device has validated its ease of application, comfort, the ability to limit at-risk shoulder motions, and the maintenance of functional shoulder motion. Although traumatic shoulder dislocation occurs most commonly in young active males between the ages of 15 and 29, the impact of recurrent dislocation risk (as high as 90%) affects the population as a whole in cumulative medical costs, lost wages and lost productivity. Recurrent dislocation risk is strongly inversely correlated to the age of initial dislocation, and older patients are more likely to incur higher rates of rotator cuff tears with dislocation. Although initial trauma is usually required to induce dislocation, re-dislocation can occur more easily during common sporting and work-related tasks. The design of a functional brace that limits at-risk shoulder behavior and supports active shoulder function will broadly impact the fields of rehabilitation, physical therapy and sports medicine. Reduced incidence of re-dislocations will reduce medical costs, increase workplace productivity, and promote a more active population.