一种烧伤后组合式肩外展矫形器的设计与临床应用

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腋下深度烧伤创面愈合后容易出现瘢痕挛缩导致肩外展受限,严重影响患者的上肢功能。佩戴肩外展矫形器是一种有效的腋下瘢痕挛缩干预手段,但目前临床常用的肩外展矫形器调节范围有限,定制静态矫形器只能维持相应的肩外展角度。且以上2种矫形器都只能单侧进行牵伸,对于两侧需要牵伸的患者,治疗比较耗时。针对上述情况,武汉大学同仁医院暨武汉市第三医院设计了一种组合式肩外展矫形器,根据患者腹部、上臂部及后腰部测量数据,裁剪低温热塑板材并塑形、组装,形成组合式矫形器。该矫形器不仅可以渐进性大范围牵伸腋下挛缩瘢痕,从而有效预防腋下瘢痕挛缩,且可根据患者肩部外展挛缩受限情况,选择单侧牵伸或双侧牵伸,节省了医务工作者和患者的治疗时间。“,”Cicatricial contracture is likely to occur at the deep burn wound under the armpits after healing, which results in limitation of shoulder abduction and seriously affects the function of upper limbs of patients. Wearing shoulder abduction orthosis is an effective intervention method for cicatricial contracture under the armpits, but the adjustable shoulder abduction orthosis commonly used clinically at present is limited in the adjustable range, and the customized static orthosis can only maintain the corresponding angle of shoulder abduction. Besides, the above two orthosis can only have the function of unilateral extention, and they are time-consuming for patients with need of bilateral extension. Aiming at the problems mentioned above, a combined shoulder abduction orthosis was designed by the Tongren Hospital of Wuhan University & Wuhan Third Hospital. The low temperature thermoplastic sheet was cut, shaped, and assembled according to the patient′s measurement data of abdomen, upper arm, and lumbar to prepare the combined shoulder abduction orthosis. This abduction orthosis can not only extend the cicatrix contracture under the armpits progressively and extensively, so as to effectively prevent the cicatricial contracture under the armpits, but also can select unilateral or bilateral extension based on the contracture limits for shoulder abduction, thus saving time for both medical workers and patients in relevant treatment.
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