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Extracorporeal Shock Wave Therapy and Ultrasound Waves Effectively ReduceSymptoms of Chronic Calcaneal Spur 体外冲击波治疗和超声波有效减轻慢性跟骨刺的症状
Pub Date : 2017-03-14 DOI: 10.4172/2329-910X.1000229
Paweł Lizis, Wojciech Kobza, G. Mańko, Barbara Para, Jarosław Jaszczur-Nowicki, Jacek Perliński
Pawel Lizis1*, Wojciech Kobza2, Grzegorz Manko3, Barbara Para4, Jaroslaw Jaszczur-Nowicki5 and Jacek Perlinski6 1Department of Education and Health Protection, Holycross College, Kielce, Poland 2Physiotherapy Laboratory, Zywiec, Poland 3Department of Ergonomics and Physiology of Physical Effort, Jagiellonian University, Cracow, Poland 4Global Care Clinical Trials, Ltd., Bannockburn, Illinois, USA 5Department of Tourism, Recreation and Ecology, Faculty of Environmental Sciences, University of Warmia and Mazury, Olsztyn, Poland 6Department of Health Sciences, University of Humanities and Economy, Elblag, Poland *Corresponding author: Pawel Lizis, Department of Education and Health Protection, Holycross College, Kielce, Poland, Tel: +48 663 793 834; E-mail: pawel_lizis@poczta.onet.pl
Pawel Lizis1*、Wojciech Kobza2、Grzegorz Manko3、Barbara Para4、Jaroslaw Jaszczur-Nowicki5和Jacek Perlinski6 1波兰基尔切Holycross学院教育与健康保护系2波兰Zywiec物理治疗实验室3波兰Cracow Jagiellonian大学人体工程学和体力生理学系4全球护理临床试验,有限公司,伊利诺伊州班诺克本,美国5波兰奥尔兹廷瓦米亚和马祖里大学环境科学学院旅游、娱乐和生态系6波兰埃尔巴格人文与经济大学健康科学系*通讯作者:波兰基尔切霍利克罗斯学院教育与健康保护系Pawel Lizis,电话:+48 663 793 834;电子邮件:pawel_lizis@poczta.onet.pl
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引用次数: 1
Association between Height of the Forefoot Transverse Arch and Kinetics orKinematics of Ankle Joint during Gait 步态中前脚横弓高度与踝关节动力学或运动学的关系
Pub Date : 2017-03-03 DOI: 10.4172/2329-910X.1000227
Tomofumi Matsushita, Y. Tashiro, Yusuke Suzuki, Seishiro Tasaka, Keisuke Matsubara, Mirei Kawagoe, Yuki Yokota, T. Sonoda, Yasuaki Nakayama, T. Fukumoto, T. Aoyama
Objective: Most studies on arch biomechanics focus on the medial longitudinal arch (MLA) and its function; however, there are fewer studies on the forefoot transverse arch (FTA) biomechanics and its function is not well understood. This study aimed at investigating the function of FTA on foot kinetics and kinematics during gait. Methods: Nineteen healthy participants (10 men, 9 women) with a mean age of 25.8 years were recruited. Each measurement was performed with the participants’ dominant foot. For evaluating FTA, transverse arch index (TAI) was measured using ultrasonic diagnostic equipment, which represented the relative height of FTA. Measurements were performed in a two-stance condition: 90% of weight bearing (90% WB), and 10% of weight bearing (10% WB). For evaluating MLA, arch height ratio (AHR) were measured with a ruler. A three-dimensional motion analysis system was used to capture and analyze foot kinetics and kinematics. Participants were instructed to walk barefoot along a 7 m walkway at regular walking pace (110 steps/minute). To examine the function of FTA, spearman’s correlation coefficients were calculated for non-parametric variables (TAI at 10% WB with foot kinetics and kinematics), to examine the relationship between MLA and FTA, (TAI at 10% WB with AHR), to examine flexibility of FTA, (the difference between TAI in 90% and 10% WB with vertical ground reaction force (GRFV)in the terminal stance). Results: A significant positive correlation was observed between TAI and max GRFV in the terminal stance (r=0.50, P=0.03). There was no significant difference between TAI at 10% WB and AHR, A significant negative correlation was observed between the difference in TAI at 90% and 10% WB and, max GRFV in the terminal stance (r=-0.64, P=0.003). Conclusions: The present study showed that GRFV in the terminal stance was positively correlated with the height of FTA, and that flexibility of FTA has relative to GRFV in the terminal stance during gait. It is important to measure flexibility of FTA as well as height of FTA so as to predict the risk of forefoot injury.
目的:弓生物力学的研究主要集中在内侧纵弓(MLA)及其功能;然而,关于前足横弓的生物力学研究较少,对其功能的认识也不清楚。本研究旨在探讨FTA在步态过程中对足部动力学和运动学的影响。方法:招募19名健康参与者(男10名,女9名),平均年龄25.8岁。每次测量都是用参与者的惯用脚进行的。利用超声诊断设备测量横弓指数(TAI)来评价FTA,该指数代表FTA的相对高度。测量在两种姿势下进行:90%负重(90%体重)和10%负重(10%体重)。用尺测量弓高比(AHR)评价MLA。利用三维运动分析系统捕获和分析足部动力学和运动学。参与者被要求赤脚以常规步行速度(110步/分钟)沿着一条7米长的人行道行走。为了检验FTA的作用,计算了非参数变量(10% WB时TAI与足部动力学和运动学)的spearman相关系数,以检验MLA与FTA之间的关系,(10% WB时TAI与AHR),检验FTA的灵活性,(90% WB和10% WB时TAI与末端站姿垂直地面反力(GRFV)之间的差异)。结果:终末体位TAI与最大GRFV呈正相关(r=0.50, P=0.03)。10% WB时TAI与AHR无显著性差异,90% WB时TAI与10% WB时TAI与末位最大GRFV呈显著负相关(r=-0.64, P=0.003)。结论:本研究显示终位GRFV与FTA高度呈正相关,且步态时FTA的柔韧性与终位GRFV相关。测量足跖关节的柔韧性和足跖关节的高度是预测前足损伤风险的重要依据。
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引用次数: 4
Celecoxib 2% Cream in Acute Soft Tissue Injuries: Randomized, Double-blind, Placebo-controlled Clinical Trial 塞来昔布2%乳膏治疗急性软组织损伤:随机、双盲、安慰剂对照临床试验
Pub Date : 2017-02-24 DOI: 10.4172/2329-910X.1000226
Villegas Rivera Geannyne, Covarrubias Pinedo Amador, R. Silvia, S. Saul, Alatorre Carranza Maria del Pilar, Rodriguez Herrera Lourdes Yolotzin, Jaime Islas Nilssa Graciela, Galaviz Muro Adriana
Objective: The aim of the study was to evaluate the efficacy of pain reduction and tolerability of topical administration of Celecoxib 2% cream compared to Celecoxib 1% cream and placebo cream in Mexican patients who had acute soft tissue injury in lower limbs. Methods: A randomized, double-blind, placebo control trial with 3 parallel groups was conducted. We include Mexicans patients older than 18 years with diagnosis of acute soft tissue injury in lower limbs. They were randomly assigned to Celecoxib 2% cream (CEL-2), Celecoxib 1% cream (CEL-1) or placebo cream (PLA). All treatments should be applied 3 times a day for a period of 7 days. Every day the pain was assessed with a Visual Analogue Scale (VAS). Secondary, we evaluate inflammation and adverse events. Results: A total of 95 patients were included. VAS on day 1 and 7 in group CEL-2 were 57.41 ± 10.39 mm and 4.34 ± 7.02 mm, in CEL-1 59.38 ± 9.37 mm and 10.41 ± 12.78 mm, and in PLA 55.61 ± 8.09 mm and 9.32 ± 9.93 mm. CEL-2 showed greater pain decrease compared to CEL-1 and PLA, p<0.05. CEL-1 group significantly decreased inflammation more than PLA, p<0.05. 15 adverse events were reported in 9 patients, none was severe. Conclusion: The results shown in the present study demonstrate that topical administration of Celecoxib cream 2%, TID for 7 days was effective in pain relief in patients with acute soft tissue injury.
目的:本研究的目的是评估墨西哥急性下肢软组织损伤患者局部施用塞来昔布2%乳膏与塞来昔布1%乳膏和安慰剂乳膏的止痛效果和耐受性。方法:采用随机、双盲、安慰剂对照试验,分为3组。我们纳入了18岁以上被诊断为下肢急性软组织损伤的墨西哥人。他们被随机分为塞来昔布2%乳膏(CEL-2)、塞来昔布1%乳膏(CEL-1)或安慰剂乳膏(PLA)。所有治疗应每天进行3次,持续7天。每天用视觉模拟量表(VAS)评估疼痛。其次,我们评估炎症和不良事件。结果:共纳入95例患者。第1天和第7天,CEL-2组的VAS分别为57.41±10.39 mm和4.34±7.02 mm,CEL-1组为59.38±9.37 mm和10.41±12.78 mm,PLA组为55.61±8.09 mm和9.32±9.93 mm。与CEL-1和PLA相比,CEL-2的疼痛减轻幅度更大,p<0.05。CEL-1组比PLA组明显减少炎症反应,p<0.05。9例患者中报告了15例不良事件,无一例为严重不良事件。结论:本研究结果表明,2%塞来昔布乳膏,TID局部给药7天,可有效缓解急性软组织损伤患者的疼痛。
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引用次数: 0
Long-Term Economical Effects of Isolated Calcaneus Fracture Depending onInsurance Status, Age, Occupation and Fracture Type 孤立性跟骨骨折的长期经济效应取决于保险状况、年龄、职业和骨折类型
Pub Date : 2017-01-16 DOI: 10.4172/2329-910X.1000225
S. Peters, J. Persson, Padhraig O´Loughlin, C. Krettek, R. Gaulke
Background: The influence of insurance status on clinical outcome and function, such as the duration of time that the patient is unable to work has not yet been fully elucidated upon in the literature, as it pertains to calcaneal fractures. These injuries are typically associated with a significant economic burden for both patient and society. In a retrospective clinical and radiological case-control study of 44 patients, with an isolated calcaneus fracture, the influence of the insurance status was evaluated. Methods: The average follow-up time period was ten years (range 4.2 to 15.0 years). Patient satisfaction was assessed using the SF-36, AOFAS-Score, ACFAS-Score, Hannover-Score and Foot Function Index. Data relating to inability to work, reduction in ability to work/degree of disability and were collected using a standardized questionnaire. Radiologic follow-up was involved evaluation of the degree of arthrosis in the subtalar joint. Results: The scoring systems employed revealed significant differences between the work liability and public statutory insured patients in the physical component (PCS) with SF-36 (p=0.003), AOFAS (p=0.002), ACFAS (p=0.002), Hannover-Score (p=0.003), FFI (p=0.001). Additionally, the work incapacity duration (p=0.006) and the frequency of detection of a reduction in ability to work and degree of disability (p=1.8 × 10-8) was significantly different between the two cohorts, and independent of age, occupational group and fracture type. Conclusion: Thus, it may be deduced that insurance status, does indeed exert a significant influence on clinical outcome and specifically, the magnitude of the duration of time when a patient is deemed unable to work.
背景:保险状态对临床结果和功能的影响,如患者无法工作的时间长短,在文献中尚未完全阐明,因为它与跟骨骨折有关。这些伤害通常与患者和社会的重大经济负担有关。在一项对44名孤立性跟骨骨折患者的回顾性临床和放射学病例对照研究中,评估了保险状态的影响。方法:平均随访时间为10年(4.2~15.0年)。使用SF-36、AOFAS评分、ACFAS评分、Hannover评分和足部功能指数评估患者满意度。使用标准化问卷收集了与无法工作、工作能力下降/残疾程度有关的数据。放射学随访包括评估距下关节的关节病程度。结果:采用的评分系统显示,工作责任和公共法定保险患者在身体成分(PCS)方面存在显著差异,SF-36(p=0.003)、AOFAS(p=0.002)、ACFAS(p=0.0002)、Hannover评分(p=0.003)、FFI(p=0.001),两组患者丧失工作能力的持续时间(p=0.006)和发现工作能力和残疾程度降低的频率(p=1.8×10-8)存在显著差异,且与年龄、职业组和骨折类型无关。结论:因此,可以推断,保险状态确实对临床结果产生了重大影响,特别是对患者被认为无法工作的持续时间的影响。
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引用次数: 2
A Case Report of Active Amniotic Band Syndrome with Progressive Lymphedema Causing Vascular Insufficiency: Radical Excision of the Overgrown Tissue 活动性羊膜带综合征伴进行性淋巴水肿导致血管功能不全一例报告:过度生长组织的根治性切除
Pub Date : 2017-01-12 DOI: 10.4172/2329-910X.1000224
S. Aleman, Bibiana Dello Russo
Introduction: Amniotic band syndrome (ABS) is an uncommon congenital anomaly characterized by multiple incapacitating manifestations. It may affect the bone, muscle, nerves, and vascular bundles according to the depth of the constriction band. Material and methods: Here we present a 2-month-old infant patient with active ABS in the lower limb at risk for amputation, in which the constriction bands were released surgically using the extensive approach. A two-step surgery was performed. In the first step, a Z-plasty of the anterior portion of the proximal constriction band was performed. In a second step, the bag on the foot was removed and subsequently the posterior part of the constrictive band was resected. Result: A follow-up of five years after surgery, respectively, revealed fully functional foot and restoration of blood supply. Conclusion: This procedure allowed to establish normal circulation in the limb with active ABS after birth. Removal of the constriction band improves the distal tissue and avoids progressive deformity. Surgery of the SBA may be performed in one or two steps.
引言:羊膜带综合征(ABS)是一种罕见的先天性异常,其特征是多种丧失能力的表现。根据收缩带的深度,它可能会影响骨骼、肌肉、神经和血管束。材料和方法:我们介绍了一名2个月大的婴儿患者,其下肢活动性ABS有截肢的风险,其中使用广泛的方法通过手术释放收缩带。进行了两步手术。在第一步中,对近端收缩带的前部进行Z形成形术。在第二步中,移除脚上的袋子,随后切除收缩带的后部。结果:术后5年的随访显示,足部功能完全,血液供应恢复。结论:该方法可以在出生后活动性ABS的肢体中建立正常的循环。移除收缩带可以改善远端组织并避免进行性畸形。SBA的手术可以分一步或两步进行。
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引用次数: 2
Multidisciplinary Approach in Foot Reconstruction 足部重建的多学科方法
Pub Date : 2017-01-01 DOI: 10.4172/2329-910X.1000E109
Francisco Javier Ga Bernal, Paloma Zayas, J. Regalado
Personally, I consider this “Cinderella role” is due to the fact that surgeons do not like to do the dirty work. The treatment of its pathology is complex, requires knowledge of its anatomy, of its biomechanics, and occasionally, after hard work, the results are not those expected. It could be said that the effort is not worthwhile, or at least less compensated for than in other fields of Orthopaedic Surgery.
就我个人而言,我认为这种“灰姑娘的角色”是由于外科医生不喜欢做肮脏的工作。它的病理治疗是复杂的,需要解剖学和生物力学的知识,有时,经过艰苦的工作,结果不是预期的。可以说,这种努力是不值得的,或者至少比其他整形外科领域的补偿要少。
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引用次数: 0
Effects of Eccentric Exercise and Extracorporeal Shock Wave Therapy onRehabilitation of Patients with Noncalcific Rotator Cuff Tendinopathy 偏心运动和体外冲击波治疗对非钙化性肩袖肌腱病患者康复的影响
Pub Date : 2017-01-01 DOI: 10.4172/2329-910X.1000222
Tien‐Wen Chen, Jyong-Huei Su, Tz-Yan Lin, Cheng-Wei Lin, Pei Shi Chou, Mao‐Hsiung Huang
Objective: In this study, in order to establish a more effective therapeutic model for the patients with chronic rotator cuff tendinosis, the authors attempted to compare the therapeutic effects of general physical therapy, eccentric contraction exercise, extracorporeal shock wave therapy (ESWT) and their combination for patients with noncalcific subscapular tendinosis. Methods: 120 patients with subscapular tendinosis Grade II tendinopathy were divided randomly into four groups: I-IV, with 30 patients in each group. In group I (GI): the patients received conventional rehabilitation program, which included 20 minute of local hot packs, 15 min interferential electrotherapy and 10 min of passive range motion exercise three times weekly for 8 weeks; in Group II: the patients received eccentric contraction exercise three times per day and a rehabilitation program as in GI; in GIII: the patients received ESWT therapy weekly except for a rehabilitation program as in GI; in GIV: they received three combination therapies including a conventional rehabilitation program, three rounds of eccentric contraction exercises per day and weekly ESWT for 8 weeks. The outcome measurements include visual analogue pain scale (VAS), range of shoulder motion, subscapular muscle peak torques, and proprioception of the affected shoulder. Results: The results showed that the combination therapy group GII-IV all had more improvement than the conventional rehabilitation program group I. However, the integrated therapy group IV had the best improvement over GII and GIII in pain reduction and improvement of range of motion, proprioception and muscle peak torques. Additionally, group III and IV had better improvement of range of motion and muscle peak torques than did GII. Conclusion: Eccentric exercise and ESWT had benefit in rehabilitation of patients with noncalcific subscapular tendinosis, and conventional rehabilitation combined with these two therapies will result in more therapeutic effects.
目的:本研究试图比较普通物理疗法、偏心收缩运动、体外冲击波疗法(ESWT)及其联合治疗非钙化性肩胛下肌腱病的疗效,以期建立一种更有效的慢性肩袖肌腱病的治疗模式。方法:120例肩胛下肌腱病变II级肌腱病变患者随机分为4组:I-IV组,每组30例。I组(GI):患者接受常规康复方案,包括20分钟局部热敷、15分钟干扰电疗和10分钟被动范围运动,每周3次,持续8周;II组:患者接受每日3次偏心收缩运动和GI组的康复计划;在GIII中:患者每周接受ESWT治疗,除了GI中的康复计划;在GIV中:他们接受了三种联合治疗,包括常规康复计划,每天三轮偏心收缩练习和每周ESWT,持续8周。结果测量包括视觉模拟疼痛量表(VAS)、肩部运动范围、肩胛下肌峰值扭矩和受影响肩膀的本体感觉。结果:综合治疗组GII-IV均优于常规康复方案组i。但综合治疗组IV在减轻疼痛、改善关节活动度、本体感觉和肌肉峰值扭矩方面均优于GII和GIII。此外,III组和IV组比GII组有更好的运动范围和肌肉峰值扭矩的改善。结论:偏心运动和ESWT对非钙化性肩胛下肌腱病患者的康复有一定的疗效,常规康复结合这两种治疗方法会获得更好的治疗效果。
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引用次数: 5
Truncated Foot Length: A Potentially More Reliable Foot Dimension for Stature Estimation 截断脚长:一个潜在的更可靠的身高估计脚尺寸
Pub Date : 2017-01-01 DOI: 10.4172/2329-910X.1000230
A. T. Salihu, A. Gwani
Abubakar Tijjani Salihu1 and Abdullahi Suleiman Gwani2* 1Department of Physiotherapy, Hasiya Bayero Paediatric Hospital, Emir’s Palace Road, Kano, Nigeria 2Department of Human Anatomy, College of Medical Sciences, Abubakar Tafawa Balewa University. PMB 0248, Bauchi, Bauchi State. Nigeria. *Corresponding author: Abdullahi Suleiman Gwani, Department of Human Anatomy, College of Medical Sciences, Abubakar Tafawa Balewa University. PMB 0248, Bauchi, Bauchi State, Nigeria, Tel: +2348139796989; E-mail: asgwani@yahoo.com
Abubakar Tijjani Salihu1和Abdullahi Suleiman Gwani2* 1尼日利亚卡诺埃米尔宫路Hasiya Bayero儿科医院物理治疗科2 Abubakar Tafawa Balewa大学医学学院人体解剖学系包奇州,PMB 0248。尼日利亚。*通讯作者:Abdullahi Suleiman Gwani, Abubakar Tafawa Balewa大学医学学院人体解剖学系。尼日利亚包奇州包奇PMB 0248,电话:+2348139796989;电子邮件:asgwani@yahoo.com
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引用次数: 0
Use of Transcutaneous Application of CO2 in Diabetic Foot Pathology 经皮CO2在糖尿病足病理中的应用
Pub Date : 2017-01-01 DOI: 10.4172/2329-910X.1000232
I. Frangež, Jure Colnaric, D. Truden
In neuropathic foot ulcers, the most prominent finding is the loss of peripheral sensation and is typically seen in diabetic patients. In addition, vasculopathy may lead to foot ulcerations in diabetic patients. CO2 therapy was found to improve chronic wound healing in patients with vascular impairment. It refers to the transcutaneous and subcutaneous application of CO2 as well as CO2 water baths for therapeutic purpose. In the method used, gaseous CO2 is applied transcutaneously using the PVR system®. CO2 is applied by means of a single-use, low-density polyethylene bag which is wrapped around the leg being treated and secured with an elastic strap. The advantages of this method, compared to injecting CO2 into subcutaneous tissue, are non-invasiveness, the absence of pain and protection against infection. Compared to CO2 balneotherapy this approach enables the use of higher CO2 concentrations, application to chronic wound patients and, with appropriate precautionary measures, prevents the increase of CO2 in the surrounding air. Finzgar et al. observed that the transcutaneous application of gaseous CO2 caused a significant increase in the Laser Doppler (LD) flux in cutaneous microcirculation in vivo in humans. The favourable clinical and microcirculatory effects of gaseous CO2 have further been observed in studies of patients with intermittent claudication as well as patients with primary and secondary Raynaud's phenomenon. The reviewed studies suggest that the increased delivery of CO2 to the ulcerated area will cause vasodilation and an increase in blood flow. The improved angiogenesis and oxygenation will result in healing of the chronic wound. This principle may be applied in the treatment of diabetic foot ulceration. Moreover, the effect on blood flow may also be important in preventive and curative treatment of patients with impaired mobility due to organic or functional causes. Further work is needed for the development of therapeutic strategies to optimize CO2 use in diabetic foot patients.
在神经性足溃疡中,最突出的发现是周围感觉的丧失,通常见于糖尿病患者。此外,血管病变可能导致糖尿病患者足部溃疡。发现CO2治疗可改善血管损伤患者的慢性伤口愈合。它是指用于治疗目的的经皮和皮下应用二氧化碳以及二氧化碳水浴。在所使用的方法中,使用PVR系统®经皮施用气态CO2。二氧化碳是通过一次性使用的低密度聚乙烯袋施用的,该袋包裹在正在处理的腿上,并用弹性带固定。与向皮下组织注射二氧化碳相比,这种方法的优点是无创、无疼痛和防止感染。与二氧化碳蒸汽疗法相比,这种方法可以使用更高的二氧化碳浓度,应用于慢性伤口患者,并采取适当的预防措施,防止周围空气中二氧化碳的增加。Finzgar等人观察到,经皮应用气态CO2可显著增加人体皮肤微循环中的激光多普勒(LD)通量。在间歇性跛行患者以及原发性和继发性雷诺现象患者的研究中,进一步观察到气态CO2的良好临床和微循环作用。综述的研究表明,向溃疡区输送的二氧化碳增加会导致血管舒张和血流量增加。血管生成和氧合的改善将促进慢性伤口的愈合。这一原理可应用于糖尿病足溃疡的治疗。此外,对血流的影响也可能是重要的预防和治疗患者的行动不便,由于有机或功能性原因。需要进一步的工作来开发治疗策略,以优化糖尿病足患者的二氧化碳使用。
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引用次数: 0
Factors Affecting Doses for Medical Staff in Orthopaedic Procedures Under X-rays Control x射线管制下骨科医护人员剂量的影响因素
Pub Date : 2017-01-01 DOI: 10.4172/2329-910X.1000235
M. Staniszewska
Interventional medical procedures performed under X-rays control became very popular. Beside of cardiology and neurosurgery, they are implemented also in non-vascular fields, like urology, orthopaedy, gastroenterology, etc. In orthopaedic procedures fluoroscopy is used to control of surgery reconstructions. The ICRP recommendations [1] and Directive of EC [2] implemented as the legal rules in Poland [3] require to use at least 2 individual dosimeters by medical staff participating in interventional procedures (IR). Despite of that, orthopaedic teams are treated as low-risk staff and thus not always are properly monitored. Nevertheless, the need of control radiation risk for this group was proved by the results of dose measurements which were conducted by nearly 3 years (2012-2015) in the orthopaedic clinics of the 3 big hospitals in Lodz (Poland). The detail dosimetric control were submitted the members of medical teams performing osteosynthesis for limb fractures. Two methods were applied: intramedullary (more complicated) and remainder (easier to perform). Each team member was equipped in 4 dosimetric tools containing thermoluminescent dosimeters to measure the equivalent doses for the eyes, skin of the hand and the neck (outside of the shield) and to evaluate effective dose. All the procedures were performed under control of X-ray fluoroscopy. The C-arm units used for that were appropriate technical quality. (Material and methods of the measurements were already described in details [4].) The observations performed during the study were as follows. Although all X-ray devices have pulsed fluoroscopy mode any team did use it! Only in one clinic (the hospital No.2) dose rate was reduced to 50%. Additionally, no member of the teams wore the protective glasses and protective gloves (even the operator). The mean doses per one procedure for operator are given in table 1 below.
在x射线控制下进行的介入性医疗程序变得非常流行。除了心脏科和神经外科外,它们也被应用于非血管领域,如泌尿外科、骨科、胃肠病学等。在骨科手术中,透视用于控制手术重建。ICRP建议[1]和欧盟指令[2]作为波兰的法律规则实施[3],要求参与介入手术(IR)的医务人员至少使用2个个人剂量计。尽管如此,骨科团队被视为低风险员工,因此并不总是受到适当的监控。然而,在波兰罗兹(Lodz)的三家大医院骨科诊所进行了近3年(2012-2015)的剂量测量结果,证明了对这一群体进行辐射风险控制的必要性。详细的剂量控制提交给进行肢体骨折植骨术的医疗小组成员。采用两种方法:髓内(更复杂)和剩余(更容易执行)。每个小组成员配备了4个剂量计工具,其中包含热释光剂量计,用于测量眼睛、手部皮肤和颈部(防护罩外)的等效剂量,并评估有效剂量。所有手术均在x线透视下进行。使用的c臂单元具有适当的技术质量。(测量的材料和方法已详细描述[4]。)在研究期间进行的观察如下。虽然所有的x射线设备都有脉冲透视模式,但任何团队都使用它!只有一家诊所(第二医院)的剂量率降至50%。此外,小组成员(甚至操作员)都没有戴防护眼镜和防护手套。操作人员每次手术的平均剂量见下表1。
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Clinical research on foot & ankle
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