No abstract available.
Braces*

Gorham-Stout disease is characterized by massive osteolysis or "vanishing bone" on radiograph. Due to its rarity, no standard Physical Medicine and Rehabilitation (PM&R) management has been published. With this comes the dilemma of managing another case of vanishing right humerus in a 13 year-old male, right handed student, with normal growth and development. To date, this could be the third documented case in the Philippines, but the first with humeral involvement, and the first to manage using a customized humeral brace. The absence of the right humerus affects the bimanual overhead and tabletop activities of the patient, for which a custom-made humeral orthosis was provided to manage the limited activities. There were improvements in activities such as writing, card turning, stacking, and lifting objects of variable weights, as well as with hand dexterity as evidenced by the standardized hand function tests done prior and post brace fitting. Being a rare bone disease with no standard management and unpredictable course, cases are managed symptomatically. For this case of an absent humerus significantly affecting upper extremity function, orthotic management is one aspect that could be recommended to achieve positive functional outcomes.
Braces

No abstract available in English.
Braces ; Scoliosis

It has been generally agreed that most fractures of the humeral shaft are best treated non-operatively although occasionally there are indications for primary operative treatment. Recent advances in internal fixation techniques and instrumentation have led to an expansion of surgical indications, and operative treatment produces higher rates of nonunion, infection and other associated complication when compared with closed treatmet techniques. Because of the significant morbidity of the operative treatment, closed intramedullary fixation techniques that provide stability of the fracture site without opening and reduce the postoperative complications, were developed. In this paper we document forty two fractures of the humeral shafts that were treated by functional bracing(Group I: 24 cases) and intramedullary fixation with functional bracing(Group II: 18 cases) between October, 1982 and August, 1986. And the obtained results were as follows: 1. The everage healing time was 9 weeks in the Group I, and 11 weeks in the Group II . 2. The non-union has not been encountered in the Group I, but non-union and delayed union were 4 cases (22.2%) in the Group II. 3. The complication rate was 9 cases(37.5%) in the Group I, and was 12 cases(66.7%) in the Group II, but deep infection did not occured in all cases. 4. The residual angulation more than 5 degrees was 20 cases(83.3%) in the Group I, and was 2 cases(11.1%) in the Group Il. However the results of the group Il were inferior ot the group I, of more proper selection of the patients, more accurate technique and adequate type of nails have been used, the better results will be taken.
Braces ; Humans ; Postoperative Complications

The authors did clinical analysis for 37 cases, ranging from 5 to 13 year old of age and following result obtained. 1. In group I partial involved type had brightful prognosis even in the neglected the cases. 2. Ischeal brace did not give any help to group II & III but in group I, it gave some help to the prognosis. 3. In untreated cases of old age group developed early arthritic changes. 4. The inital radiological bony changes in early L-C-P. cases was the demineralization of the subchondral area and subsequently subohondral vaccum phenomena followed.
Braces ; Humans ; Prognosis

No abstract available in English.
Braces ; Child ; Hip ; Humans ; Thigh

Until now because there are many published journals with a variety of opinions so I will stratify these articles by giving weighted value on grade evaluation which depend on each institution (written author and co-authors) and external evaluate status (SCI, SCIE, impact factor) rather than the outcomes provided by each article. Consequently, before evaluating publicized papers, study quality assessment of each interesting paper should be performed by mean of gauging the quality of evidence. Reviewing these articles, a grade of medical literature was divided into the following 5 levels as level I (randomized controlled study), level II (non-randomized controlled study), level III (case-control study), level IV (case series), and level V (expert opinions). However, in present article I concluded only involved medical literatures with weighted value of level I and II evidence.
Adolescent* ; Braces ; Humans ; Orthotic Devices ; Scoliosis*

The management of thoraco-lumbar fractures remains controversial. Different authors have advocated immobilization, external bracing or internal fixation by either anterior or posterior approaches. To stabilize the fracture and avoid an unne cessary fixation of an uninjured segment, posterior monosegmental fixation was performed in Type B1 fractures according to the classification of Magerl et al, with nearly intact vertebral body for load support. Two patients underwent fixation with 4 titanium pedicle screws, one level above and directly into the fractured vertebra body. Patients had a stable fixation at 6 months following surgery. No patients experienced neurological deficit or had developed a delayed kyphotic deformity. Single level fixation for selected cases of thoracolumbar fracture(Type B1 fractures) may be considered as an effective procedure to obtain fixation and fusion. But it is necessary to get a further follow-up period, further cases and especially biomechanical support.
Braces ; Congenital Abnormalities ; Humans ; Immobilization ; Spine ; Titanium

C1-C2 transarticular screw fixation has been a preferred method for the fixation of atlantoaxial subluxation caused by the rheumatoid arthritis or recurrent subluxation caused by postoperative non-union. However, it has required extensive occipitocervical fusion or rigid external orthoses such as halo brace after cable fixation especially when the patient has the prominent transverse foramen precluding the safe placement of the C1-C2 transarticular screw. The author applied a pair of Halifax interlaminar clamps from C1 to C3 following the C1-C2 cable fixation in one patient with rheumatoid atlantoaxial subluxation and the other with recurrent subluxation after postoperative non-union. The prominent transverse foramen in both patients precluded the safe passage of the C1-C2 transarticular screw. Both patients were maintained in semirigid external orthoses by using philadelphia collar for 3 months after surgery. One has been doing well for 1 year and the other for 5 months following surgery. In conclusion, the application of the Halifax interlaminar clamps from C1 to C3 in addition to the C1-C2 cable fixation can be a useful alternative procedure circumventing extensive occipitocervical fusion for patients with the prominent transverse foramen precluding the safe placement of the C1-C2 transarticular screw, thereby not sacrificing the motion between occiput and atlas.
Arthritis, Rheumatoid ; Braces ; Humans ; Orthotic Devices

OBJECTIVE: The biomechanical stabilities between the anterior plate fixation after anterior discectomy and fusion (ACDFP) and the posterior transpedicular fixation after ACDF(ACDFTP) have not been compared using human cadaver in bilateral cervical facet dislocation. The purpose of this study is to compare the stability of ACDFP, a posterior wiring procedure after ACDFP(ACDFPW), and ACDFTP for treatment of bilateral cervical facet dislocation. METHODS: Ten human spines(C3-T1) were tested in the following sequence: the intact state, after ACDFP(Group 1), ACDFPW(Group 2), and ACDFTP(Group 3). Intervertebral motions were measured by a video-based motion capture system. The range of motion(ROM) and neutral zone(NZ) were compared for each loading mode to a maximum of 2.0Nm. RESULTS: ROMs for Group 1 were below that of the intact spine in all loading modes, with statistical significance in flexion and extension, but NZs were decreased in flexion and extension and slightly increased in bending and axial rotation without significances. Group 2 produced additional stability in axial rotation of ROM and in flexion of NZ than Group 1 with significance. Group 3 provided better stability than Group 1 in bending and axial rotation, and better stability than Group 2 in bending of both ROM and NZ. There was no significant difference in extension modes for the three Groups. CONCLUSION: ACDFTP(Group 3) demonstrates the most effective stabilization followed by ACDFPW(Group 2), and ACDFP(Group 1). ACDFP provides sufficient strength in most loading modes, ACDFP can provide an effective stabilization for bilateral cervical facet dislocation with a brace.
Braces ; Cadaver ; Diskectomy ; Dislocations* ; Humans ; Spine