Anderson Hamish, Hoy Greg
Anderson Hand Therapy, The Avenue Physiotherapy Centre, Windsor, Victoria, Australia; Melbourne Orthopaedic Group, Windsor, Victoria, Australia.
Melbourne Orthopaedic Group, Windsor, Victoria, Australia.
J Hand Ther. 2016 Apr-Jun;29(2):199-204. doi: 10.1016/j.jht.2016.02.007. Epub 2016 Mar 2.
Case series.
This paper describes conservative guidelines for the management of scapho-lunate interosseous ligament (SLIL) injury including fabrication of an orthosis that restricts active wrist movement to the dart-throwers (DTM) plane.
The dart throwers' orthosis (DTO) was designed as a response to biomechanical studies suggesting that restraining motion to the DTM would off-load a deficient SLIL.
After six weeks of wearing the DTO, the 5 patients in this case series initiated an exercise program that incorporated wrist proprioceptive training and specific muscle strengthening.
The DTO was designed to incorporate controlled movement in order to better integrate the secondary wrist stabilizers in wrists that had a deficient SLIL. The orthosis and the exercise program harnessed proprioceptive influences using active motion within the DTM plane, and stimulated mechanoreceptors so as to enhance stability.
All patients demonstrated improvement in subjective and objective outcomes including self-reported pain and function.
Orthotic intervention that controls motion within the DTM, combined with an appropriate proprioceptive rehabilitation program, may provide a viable conservative treatment option for patients with a similar clinical presentation.
病例系列。
本文描述了舟月骨间韧带（SLIL）损伤保守治疗的指南，包括制作一种将主动腕关节活动限制在掷镖者（DTM）平面的矫形器。
设计掷镖者矫形器（DTO）是为了响应生物力学研究，该研究表明将运动限制在DTM平面可减轻受损的SLIL的负荷。
在佩戴DTO六周后，该病例系列中的5名患者开始了一项运动计划，其中包括腕关节本体感觉训练和特定肌肉强化训练。
DTO的设计旨在纳入可控运动，以便更好地整合SLIL受损的腕关节中的次要腕关节稳定器。矫形器和运动计划利用DTM平面内的主动运动来利用本体感觉影响，并刺激机械感受器以增强稳定性。
所有患者在主观和客观结果方面均有改善，包括自我报告的疼痛和功能。
控制DTM内运动的矫形器干预，结合适当的本体感觉康复计划，可能为具有类似临床表现的患者提供一种可行的保守治疗选择。
4级。
