Dobyns J H
Hand Clin. 1986 May;2(2):373-81.
Nonsurgical problems and complications of orthotist-prosthetist techniques are not addressed in this article. There are a number of complications, such as decubiti, joint contracture or damage, tendon injury, wound healing, etc., which are not discussed because they are similar in cause, identification, and treatment to the same adult problems. Though it is possible to list the more common complications seen for each congenital anomaly, the tedious repetitiveness of such an approach dissuaded the author. General principles can always be specifically applied when the occasion requires. It is also possible to detail painstakingly the techniques of coping with each complication, but such would require book rather than chapter exegesis, and those who need these details are referred to the bibliography. The theme of this article is that there is no longer much distinction in the mind of the consumer clientele between the problem of the congenital anomaly, the results of treatment, and the complications of those treatments. The provider must therefore be wary, extensively informed, and exceedingly communicative, to the point of suggesting secondary consultation as warranted or desired. Despite this almost adversarial approach, the rewards are still great, for more can be accomplished than ever before, the child will seldom show motivational problems in using what is provided, and gratitude is not lost coinage.
本文未涉及矫形师 - 假肢师技术的非手术问题及并发症。存在许多并发症，如褥疮、关节挛缩或损伤、肌腱损伤、伤口愈合等，因这些并发症在成因、识别及治疗方面与成人的同类问题相似，故未作讨论。尽管有可能列出每种先天性异常较为常见的并发症，但这种做法的冗长重复性让作者望而却步。在必要时，通用原则总能具体应用。详尽阐述应对每种并发症的技术也是可行的，但这需要写成一本书而非一章的注释，需要这些细节的人可参考参考文献。本文的主题是，在消费者客户群体的认知中，先天性异常问题、治疗结果及这些治疗的并发症之间已不再有太大区别。因此，提供者必须谨慎、信息充分且沟通极为顺畅，必要时甚至要建议进行二次咨询。尽管采取这种几乎是对抗性的方法，但回报依然丰厚，因为能取得比以往更多的成果，孩子在使用所提供的器具时很少会出现动机问题，感恩也并非毫无价值。
