Hand and arm function and rehabilitation nerve muscle apparatus after the replantation of large segments of upper limb
L. Lasn (Tallinn Long Term Hospital), A. Tikk (Tartu University)
The treatment with physical methods is one of the oldest to give back the hand function after injures or surgical rehabilitation.
In this paper we have studied more closely the action of three different physical rehabilitation complexes. In total we have examined 77 patients who had had the replantation of large upper limb segments on the level of brachium, antebrachium and manus. Patients age ranged from 18 to 47 years. Twelve of them were women, five of them had external fixation device, four patients had nerve-muscle flap transposition and two patients had had replantation of both antebrachium. Thirty patients belonged to the control group and were subjected to an ordinary rehabilitation program. The second group comprised 23, and the third group 24 patients. Different electrical stimulation methods (TES and MTES) were used in the treatment of patients in these two groups. According to statistical analysis and our experience, we concluded, that the patients in the second group who had had the ordinary rehabilitation complex and were also treated by MTES shoved the best functional results.
HIROSHIHA UNIVERSITY CM BRACE FOR OSTEOARTHRITIS OF CM JOINT
Noriyo Takahashi (Hiroshima University, Hiroshima, Japan), Muneshige Hiroshi, Kimura Hiroaki, Asou Tomohiro, Yoshimura 0samu, Ikuta Yoshikazu
Purpose: We developed Hiroshima University carpometacarpal joint brace for (H.U.CM brace) osteoarthritis of the carpometacarpal joint at 1987. H.U.CM brace is composed of cuff, band, and pad and brace weight is 15 g. From IP joint of thumb to proximal of wrist joint is fixed with soft flexible plastic.
Material: Between 1987 and 1996, we had applied H.U.CM brace to 20 patients of degenerative osteoarthritis (25 hands).
Result: Result were excellent in 21, good in 2, poor in 1, unknown in 1. H.U.CM brace application period was from 3 weeks to 5 years 4 months. Six cases of 24 cases could be free from H.U.CM brace within 3 months.
Discussion: The mechanism of H.U.CM brace is to support 1st metacarpal for at abducted position by cuff and to decrease excursion of abductor pollicis brevis and flexor pollicis brevis by pressure of pad. So H.U.CM brace dose not disturb activity of daily life so much.
Conclusion: Twenty one cases of 25 osteoarthritis cases (84%) has recovered to the level of ADL without brace by H.U.CM brace.