OBJECTIVE: To observe the clinical efficacy of 3D printing spinal external fixator combined with McKenzie therapy for patients with lumbar dics herniation (LDH). METHODS: Sixty patients with LDH between January 2022 and January 2023 were enrolled. Among them, 30 patients were given McKinsey training. According to different treatment methods, all patients were divided into McKenzie group and McKenzie + 3D printing group, 30 patients in each group. The McKenzie group provided McKenzie therapy. The McKenzie + 3D printing group were treated with 3D printing spinal external fixation brace on the basis of McKenzie therapy. Patients in both groups were between 25 and 60 years of age and had their first illness. In the McKenzie group, there were 19 males and 11 females, with an average age of (48.57±5.86) years old, and the disease duration was (7.03 ±2.39) months. The McKenzie + 3D printing group, there were 21 males and 9 females, with an average age of (48.80±5.92) years old, and the disease duration was(7.30±2.56) months. Pain was evaluated using the visual analogue scale (VAS), and lumbar spine function was assessed using the Oswestry disability index (ODI) and the Japanese Orthopaedic Association (JOA) score. VAS, ODI and JOA scores were compared between two groups before treatment and at 1, 3, 6, 9 and 12 months after treatment. RESULTS: All patients were followed up for 12 months. The VAS for the McKenzie combined with 3D printing group before treatment and at 1, 3, 6, 9, and 12 months post-treatment were(6.533±0.860), (5.133±1.008), (3.933±0.868), (2.900±0.759), (2.067±0.640), (1.433±0.504), respectively. In the McKenzie group, the corresponding scores were (6.467±0.860), (5.067±1.048), (4.600±0.968), (3.533±1.008), (2.567±0.728), (1.967±0.809), respectively. The ODI of the McKenzie group before treatment and at 1, 3, 6, 9, and 12 months post-treatment were (41.033±6.810)%, (37.933±6.209)%, (35.467±6.962)%, (27.567±10.081)%, (20.800±7.531)%, (13.533±5.158)%, respectively. For the McKenzie combined with 3D printing group, the corresponding ODI were(38.033±5.605)%, (33.000±6.192)%, (28.767±7.045)%, (22.200±5.517)%, (17.700±4.836)%, (11.900±2.771)%, respectively. The JOA scores of the McKenzie combined with 3D printing group before treatment and at 1, 3, 6, 9, and 12 months post-treatment were(8.900±2.074), (13.133±2.330), (15.700±3.583), (20.400±3.480), (22.267±3.084), (24.833±2.640), respectively. In the McKenzie group, the corresponding scores were(9.200±2.091), (12.267±2.406), (15.333±3.198), (18.467±2.240), (20.133±2.751), (22.467±2.849), respectively. Before the initiation of treatment, no statistically significant differences were observed in the VAS, ODI, and JOA scores between two groups (P>0.05). At 3, 6, 9, and 12 months post-treatment, the VAS in the McKenzie combined with 3D printing group was significantly lower than that in the McKenzie group, and the difference was statistically significant (P<0.05). The comparison of ODI between two groups at 1, 3, 6, 9, and 12 months post-treatment revealed statistically significant differences (P<0.05). At 6, 9, and 12 months post-treatment, the JOA score in the McKenzie combined with 3D printing group was significantly higher than that in the McKenzie-only group, and the difference was statistically significant (P<0.05). CONCLUSION The combination of 3D printed functional spinal external fixation brace with McKenzie therapy can significantly improve and maintain lumbar function in patients with LDH.
Humans ; Male ; Female ; Middle Aged ; Printing, Three-Dimensional ; Intervertebral Disc Displacement/surgery* ; External Fixators ; Lumbar Vertebrae/surgery* ; Adult ; Braces ; Treatment Outcome

OBJECTIVE: To explore clinical effect of high-intensity laser therapy(HILT) combined with targeted hand function training on pain and lateral pinch force in grade 1-2 thumb carpometacarpal(CMC) osteoarthritis(OA). METHODS: From April 2020 and April 2022, 42 female patients with thumb CMC OA grade 1 to 2, aged from 58 to 80 years old with an everage of (68.90±7.58) years old were divided into observation group of 21 patients who received HILT and targeted hand function training for 4 weeks, and 21 patients in control group who received ultrashort wave therapy combined with using of an orthosis for 4 weeks. Visual analogue scale(VAS) was applied to evaluate degree of pain, function of finger was evaluated by dynamometer to measure lateral pinch force at baseline, immediately following intervention at 4 and 12 weeks following intervention. RESULTS: VAS and lateral pinch force at immediately and 12 weeks after intervention betwwen two groups were better than that of before intervention(P<0.05). Compared with control group, the degree of pain in observation group improved more(immediately after intervention t=3.37, P<0.05, 12 weeks after intervention t=9.05, P<0.05), lateral pinch force higher than that of control group (immediately after intervention t=-2.55, P<0.05, 12 weeks after intervention t=9.51, P<0.05). CONCLUSION High-intensity laser therapy combined with targeted hand function training is more effective than traditional methods in improving pain and lateral pinch force in grade 1-2 thumb carpometacarpal osteoarthritis.
Humans ; Female ; Middle Aged ; Aged ; Aged, 80 and over ; Thumb ; Laser Therapy ; Braces ; Osteoarthritis/therapy* ; Pain

BACKGROUND: Scoliosis secondary to neurofibromatosis type 1 (NF1) in children aged <10 years is an important etiology of early-onset scoliosis (EOS). This study was performed to investigate the curve evolution of patients with EOS secondary to NF1 undergoing bracing treatment and to analyze high-risk indicators of rapid curve progression. METHODS: Children with EOS due to NF1 who underwent bracing treatment from 2010 to 2017 were retrospectively reviewed. The angle velocity (AV) at each visit was calculated, and patients with rapid curve progression (AV of >10°/year) were identified. The age at modulation and the AV before and after modulation were obtained. Patients with (n = 18) and without rapid curve progression (n = 10) were statistically compared. RESULTS: Twenty-eight patients with a mean age of 6.5 ± 1.9 years at the initial visit were reviewed. The mean Cobb angle of the main curve was 41.7° ± 2.4° at the initial visit and increased to 67.1° ± 8.6° during a mean follow-up of 44.1 ± 8.5 months. The overall AV was 6.6° ± 2.4°/year for all patients. At the last follow-up, all patients presented curve progression of >5°, and 20 (71%) patients had progressed by >20°. Rapid curve progression was observed in 18 (64%) patients and was associated with younger age at the initial visit and a higher incidence of modulation change during follow-up (t = 2.868, P = 0.008 and <0.001, respectively). The mean AV was 4.4° ± 1.2°/year before modulation and 11.8° ± 2.7°/year after modulation (t = 11.477, P < 0.010). CONCLUSIONS Curve progression of >10°/year is associated with younger age at the initial visit, and modulation change indicated the occurrence of the rapid curve progression phase.
Braces ; Child ; Child, Preschool ; Disease Progression ; Humans ; Neurofibromatosis 1/complications* ; Retrospective Studies ; Scoliosis/diagnostic imaging* ; Treatment Outcome

OBJECTIVE: To study and analyze the clinical effect of the self-developed new adjustable weight-bearing rehabilitation brace in the rehabilitation of the femoral intertrochanteric fracture after the operation of PFNA. METHODS: From July 2015 to June 2017, 62 patients with typeⅡ (Evans-Jensen classification) intertrochanteric fracture of femur were treated with PFNA internal fixation. There were 11 males and 19 females in the routine rehabilitation group, with an average age of (70.73± 6.09) years;17 males and 15 females in the brace rehabilitation group, with an average age of (71.25±6.60) years. Among them, the patients in the routine rehabilitation group recovered according to the routine method, and the patients in the support rehabilitation group used the self-developed new adjustable weight-bearing rehabilitation support of lower limbs to assist the early rehabilitation. The pain intensity(VAS score), weight-bearing of affected limb, clinical healing time of fracture, Harris score and complications were recorded and analyzed. RESULTS: Nine patients lost their visit half a year later, the other 53 patients were followed up for 9 to 18 months. The VAS score at 1, 3, 6 months after operation of brace rehabilitation group was lower than that of routine rehabilitation group(<0.05). The weight bearing of the limbs in the rehabilitation group was significantly higher than that in the conventional rehabilitation group(<0.05), but the clinical healing time of fracture in the brace rehabilitation group was shorter than that in the routine rehabilitation group(<0.05). In addition, the Harris score of the postoperativebrace rehabilitation group was better than that of the conventional rehabilitation group(<0.05). The incidence of complications was lower than that of the conventional rehabilitation group(=0.048). CONCLUSION In the rehabilitation of Evans Jensen typeⅡintertrochanteric fracture after PFNA internal fixation, the new self-developed adjustable weight-bearing rehabilitation brace can significantly relieve postoperative pain, regulate and moderately increase the stress stimulation at the fracture end, so as to promote fracture healing, accelerate the recovery of hip joint function, reduce the incidence of complications, and its clinical effect is safe and reliable.
Aged ; Bone Nails ; Braces ; Female ; Fracture Fixation, Intramedullary ; Hip Fractures ; Humans ; Lower Extremity ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Weight-Bearing

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

Adolescent idiopathic scoliosis (AIS) is the peripubertal development of spinal curvature of a minimum of 10°. AIS is thought to be attributable to genetic factors, nutrition, early exposure to toxins, and hormonal dysregulation. Recent literature suggests these factors may compound to determine both disease onset and severity. Currently, treatment is limited to observation, bracing, and surgical intervention. Intervention is presently determined by severity and risk of curve progression. As they emerge, new therapies may target specific etiologies of AIS.
Adolescent ; Braces ; Humans ; Scoliosis ; Spinal Curvatures

PURPOSE: Cup-cage construct technique was developed to address the massive acetabular defects during revision hip arthroplasty. Indications have extended to complex acetabular fractures with pelvic discontinuity necessitating acute total hip arthroplasty. However, its use is constrained in low socioeconomic countries due to non-availability of the original cages from Trabecular Metal Acetabular Revision System and high cost. We used a novel technique using the less expensive Burch-Schneider (BS) cage and Trabecular Metal Revision Shell (TMRS) to address the problem. MATERIALS AND METHODS: We reviewed a consecutive series of 8 cases of acetabular fractures reconstructed using a ‘cup-cage construct’ technique using a BS cage along with a TMRS. The mean age of the patients was 61.4 years. Patients were followed up for a mean period of 50.5 months (24 to 72 months). The patients were assessed clinically with Harris Hip Score and radiologically with serial X-rays. RESULTS: All the patients were available at the latest follow up. The mean Harris Hip Score was 87.2. There was no radiological evidence of failure. One patient had dislocation two months following the surgery, which was treated by closed reduction and hip abduction brace. One patient developed an infection at 3 weeks necessitating debridement. The same patient had sciatic nerve palsy that recovered after 4 months. CONCLUSION: This novel technique of the cup-cage construct seems to provide a stable construct at short to midterm follow-up. However, a long-term follow up would be required.
Acetabulum ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Braces ; Debridement ; Dislocations ; Follow-Up Studies ; Hip ; Humans ; Sciatic Neuropathy

PURPOSE: To compare the efficacy between cast immobilization and functional treatment using an ankle brace as a treatment for acute lateral ankle sprain. MATERIALS AND METHODS: This study reviewed the medical records of 157 acute ankle sprain patients who were treated between 2009 and 2014. A total of 101 cases were included in this study except for cases with a combined injury, and could not be followed up for eight weeks after the first visit. The patients were divided according to the treatment modality: a cast immobilization group (64 cases) and functional treatment group (37 cases). The clinical outcomes were assessed retrospectively based on the medical records of each group. The residual symptoms, such as pain, swelling, and instability, at three weeks after the primary treatment and at the last visit were compared. RESULTS: The residual pain and instability were significantly common in the functional treatment group at three weeks. Five cases (7.8%) of pain and one case (1.6%) of instability were in the cast group whereas nine cases (24.3%) of pain and six cases (16.2%) of instability in functional treatment group (p=0.021, p=0.014). On the other hand, there was no meaningful difference at the last follow-up. Residual pain, swelling, and instability at the last visit were noted in three (4.7%), six (9.4%), and four cases (6.3%) in the cast group, and three (8.1%), three (8.1%), and three (8.1%) were observed in the functional treatment group. Six patients refused cast immobilization. CONCLUSION: Although there was no significant difference at the last follow-up, cast immobilization appears to be more effective than a functional brace in terms of early pain relief and early restoration of ankle stability as a treatment for acute ankle lateral sprain in this study.
Ankle Injuries ; Ankle ; Braces ; Follow-Up Studies ; Hand ; Humans ; Immobilization ; Medical Records ; Retrospective Studies ; Sprains and Strains

PURPOSE: To improve pulmonary function and decrease in balance ability with increasing forward head position and vertebral curvature, we applied Figure-8 brace to confirm the immediate effect on vital capacity and balance and to see if it is applicable. METHODS: A total of 34 elderly women aged 65 or older and young women in their 20s with FHP were screened to measure vital capacity, measuring the forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), and measuring the foot pressure to see the change in balance. For statistical analysis, the difference between pre and post values was compared using pared t-test. RESULTS: As a result of vital capacity measurements, there was no significant difference between FEV1 and FVC for women over 65 years old (p>0.05). Young women in their 20s had no significant difference in FEV1 (p>0.05), and FVC had significant differences (p<0.05). In measuring foot pressure to measure balance, both women aged 65 and above and young women in their 20s had a significant decrease in anterior foot pressure, and a significant increase in posterior foot pressure (p<0.05). CONCLUSION: The results of this study did not positively affect the vital capacity of elderly women with FHP. However, the significant increase in vital capacity of young women in their 20s suggests that contraction of the abdominal muscle is necessary during forced expiration. Therefore, it is believed that proper application and therapeutic interventions should be combined when applying Figure-8 brace.
Abdominal Muscles ; Aged ; Braces ; Female ; Foot ; Forced Expiratory Volume ; Head ; Humans ; Posture ; Vital Capacity

OBJECTIVE: To explore the short-term clinical efficacy of manipulation reduction-combined with small splint and 3D printing wrist brace external fixation of wrist brace for Colles fracture and the advantages of using the brace. METHODS: A total of 60 patients with Colles fractures who were treated in Zhongshan Hospital of Traditional Chinese Medicine from February to December 2017 were selected. Patients were randomly divided into 2 groups according to the order of treatment, with 30 patients in the control group, including 13 males and 17 females, aged from 16 to 66 years, with a mean of (49.46±12.63) years; the time from injury to consultation ranged from 3 to 18 h, averaged (6.86±3.15) h. In the experimental group, there were 30 cases, 12 males and 18 females, ranging in age from 14 to 68 years old, with a mean of (46.73±14.40) years old; the time from injury to consultation ranged from 3 to 19 h, averaged(7.06±3.45)h. All the patients in the experimental group and the control group were treated with the same doctor's manipulation to reduce the fracture. The small splints were applied for external fixation after the satisfactory reduction shown in the X-ray. After 1 week of fracture treatment, the small splints were removed from the patients in the experimental group and the 3D printing braces were replaced to maintain fixation until the fracture healed. In the control group, small splints were maintained until the fracture healed. Wrist joint X-ray films were taken before and after reduction and 4 weeks after reduction to observe the palmar inclination angle, ulnar deviation angle, radius height and compare; VAS score and swelling degree score were recorded before and after reduction for 1 and 2 weeks; Cooney and PRWE score of wrist joint were compared after 6 to 8 weeks of reduction. RESULTS: The VAS score of 2 weeks after reduction was 2.40±0.49 in the experimental group and 2.43±0.50 in the control group. There was no statistical difference in the VAS score between the two groups before and after reduction(=0.364). The swelling degree of 2 weeks after reduction was 0.50±0.50 in the experimental group and 0.53±0.50 in the control group. There was no statistical difference in the swelling degree between the two groups before and after reduction(=0.746). The Cooney and PRWE scores of the experimental group were better than those of the control group 6 to 8 weeks after reduction (<0.05), and the anatomical characteristics of palmar inclination, ulnar deviation and radial shortening of the experimental group were better than those of the control group(<0.05). CONCLUSIONS 3D printing braces are light and breathable, comfortable and beautiful, and convenient for dressing. The combination of small splint sequentially applied to Colles fracture has a definite clinical effect, which enriches the means of external fixation treatment. It is believed that with the deepening of clinical research, the design and materials of 3D printing braces as well as their application in future medical treatment will be further developed.
Adolescent ; Adult ; Aged ; Braces ; Colles' Fracture ; Female ; Fracture Fixation ; Humans ; Male ; Middle Aged ; Printing, Three-Dimensional ; Radius Fractures ; Splints ; Young Adult