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盲人的骨科问题。

Orthopaedic problems in the blind.

作者信息

Khan Abdul Qayyum, Abbas Mohammad Baqar, Sherwani M K A, Khan Mohammad Jesan, Asif Naiyer, Kamal Danish

机构信息

Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, 202002, India.

Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.

出版信息

J Clin Orthop Trauma. 2023 Oct 13;45:102261. doi: 10.1016/j.jcot.2023.102261. eCollection 2023 Oct.

Abstract

BACKGROUND

Blindness is a common problem in every society and country. The problem ranges from complete blindness to partially sighted in the affected population. India has close to 12 million visually impaired people. Orthopaedic problems are not uncommon in blind. Orthopaedic Surgeons though had been aware of the postural and gait abnormalities in blind but very few published studies have systematically focused on the effect of blindness on the development of posture and gait.

METHODS

Case Control study done for the orthopaedic evaluation of the blind and partially sighted individuals. The study population included 242 students of Ahmadi School for the Blind, Aligarh Muslim University, Aligarh (India), as the cases and another matched set of 250 non-blind children. All the children were assessed for the orthopaedic problems like degree of ligamentous laxity, spinal alignment, foot morphology and alignment of hips, knees and ankles. Standing posture and gait were also examined and recorded. Ligamentous laxity was assessed according to the method adopted by Beighton et al. Chi-square test was applied using IBM SPSS 23.0.

RESULTS

139 children (57.4 %) were found to have laxity of the ligaments. 72 children (29.7 %) had spine deformities, out of which kyphosis was present in 34 (47.2 %), scoliosis in 23 (31.9 %), lordosis in 13 (18.0 %), and meningomyelocele in 2 (2.9 %) children. 119 children (49.1 %) had foot deformities. 37 children (15.2 %) had knee deformity. 22 children (9.0 %) showed evidence of cerebral palsy. 216 children (89.2 %) had varying degrees of postural abnormalities. The data was statistically significant when compared with the control group (P < 0.05).

CONCLUSION

Blindness causes a wide range of complicated sensory and motor problems that frequently forces people into isolation. Blind rehabilitation requires an interdisciplinary approach. Orthopaedic problems are quite common in blind individuals and should be dealt separately.

摘要

背景

失明在每个社会和国家都是一个常见问题。该问题涵盖了受影响人群中从完全失明到部分视力受损的情况。印度有近1200万视力障碍者。骨科问题在盲人中并不罕见。骨科医生虽然已经意识到盲人存在姿势和步态异常,但很少有已发表的研究系统地关注失明对姿势和步态发育的影响。

方法

对盲人和部分视力受损个体进行骨科评估的病例对照研究。研究人群包括印度阿里格尔穆斯林大学阿里格尔艾哈迈迪盲人学校的242名学生作为病例组,以及另一组匹配的250名非盲儿童。对所有儿童进行骨科问题评估,如韧带松弛程度、脊柱排列、足部形态以及髋、膝和踝关节的排列。还对站立姿势和步态进行了检查和记录。根据Beighton等人采用的方法评估韧带松弛程度。使用IBM SPSS 23.0进行卡方检验。

结果

发现139名儿童(57.4%)存在韧带松弛。72名儿童(29.7%)有脊柱畸形,其中34名(47.2%)有驼背,23名(31.9%)有脊柱侧弯,13名(18.0%)有脊柱前凸,2名(2.9%)儿童有脊髓脊膜膨出。119名儿童(49.1%)有足部畸形。37名儿童(15.2%)有膝关节畸形。22名儿童(9.0%)有脑瘫迹象。216名儿童(89.2%)有不同程度的姿势异常。与对照组相比,数据具有统计学意义(P < 0.05)。

结论

失明会导致广泛的复杂感觉和运动问题,常常迫使人们陷入孤立。盲人康复需要跨学科方法。骨科问题在盲人中相当常见,应单独处理。

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