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진영 허
5 years ago
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1 제 5 강. 손관절보조기

2 중수지절관절에대한보조기 MP flexor orthosis Common Name: Knuckle bender 목적및구성 : dorsal hand band(d), dorsal finger band(d), palmar rod(p) 두개의밴드의양쪽에돌출된후크에고무줄을연결시켜서 MP를굴곡시키는작용을함.

3 MP flexor orthosis

5 MP extensor orthosis Common Name: reverse knuckle bender 목적및구성 : dorsal hand band(d), palmar finger rod(p), palmar pad(p) 로구성. dorsal hand band의후크와고무밴드를연결하여 MP를신전시키는작용을함.

6 MP extensor orthosis

8 Dorsal forearm-based Dynamic Arching Springwire D1-5 MP Assistive-Extension Orthosis Common Name: Radial nerve splint, MP extensor assist 목적및구성 : MP extensor가약하거나마비되었을때보조해주기위한방법으로고무줄이나스프링들을이용. MP의굴곡은제한하고신전을보조 적응증 : Radial nerve 손상

9 Radial nerve splint

10 Dorsal forearm-based Dynamic Arching Springwire D1-5 MP Assistive-Extension Orthosis

11 Finger extension assist

12 Dorsal forearm-based Dynamic Arching Spring-wire D1-5 MP Assistive-Extension Orthosis

13 Dorsal forearm-based Dynamic Arching Springwire Wrist and D1-5 MP Assistive-Extension Orthosis

14 Radial nerve splint

15 Dorsal forearm-based Dynamic low profile wrist and D2-5 MP Assistive-Extension Orthosis

17 Circumferential hand-based dynamic arching spring-wire MP assistiveextension orthosis radial nerve 손상시 wrist extensor 에신경의 reinnervation 이될때

18 Circumferential hand-based dynamic arching spring-wire MP assistive-extension orthosis

19 Circumferential hand based dynamic tubeoutrigger MCP assistive-extension orthosis

20 Volar forearm-based Dynamic D2-5 MP Corrective flexion Orthosis Common Name: Dynamic MP flexion splint 목적 : MP의굴곡범위를증가시키기위해 MP의 collateral ligament에 stress를주기위해 적응증 : collateral ligament의단축으로인한 MP의신전구축. 주상골 (navicular) 방향으로당김확인

22 MP extension stop assembly Common Name: dorsal lumbrical bar 목적및구성 : MP 관절을굴곡시킨상태에서 IP 관절을신전시키기위해서 opponens hand splint 의 dorsal bar 위 l 에 T 자형태의금속을연결하여 MP 를약 정도구부려보조기와손가락사이의공간이있도록유지시킨다. MP 관절을신전시키면 T 밴드에걸려더이상신전되지못하며 IP 는 extrinsic long extensor 에의해신전된다.

23 finger deviation splint 목적및구성 : MP 관절의척골측편위를방지하기위해서보조기의 MP 관절위에현수막대를설치하고개개의손가락에가죽으로된루프를끼워요골측으로쏠리도록한다. 적응증 : 류마치스관절염

24 Volar Forearm-Based Static Wrist and D2-5 MP Stabilizing Orthosis Common Name: Wrist MP splint 목적 : wrist와 MP의고정, 염증과통증의경감, 관절기형의예방과수정 적응증 : 관절염증 ( 류마치스관절염, 수근관증후군 )

25 Dorsal Forearm-based dynamic MP-IP protective flexion and MP extension-blocking orthosis Common Name: Flexor tendon repair splint 목적 : MP와 IP의능동적인신전을제한하고수동적이고정적인굴곡자세를취할때유착을최소화하고열상의위험을줄인상태에서건회복의최적상태를만들기위해 적응증 : Flexor tendon 열상 (laceration)

27 Bivalved forearm-based dynamic MP-IP protectiveextension and flexion-bloking orthosis Common Name: Extensor tendon repair splint 목적 : MP 의능동적굴곡을제한 하고수동적이고정적인신전자세 를취할때유착을최소화하고열 상의위험을줄인상태에서건회 복의최적상태를만들기위해 적응증 : Extensor tendon 열상 (laceration)

28 Volar Hand-based static D2-5 MP-stabilizing orthosis Common Name: static ulnar drift/deviation splint, trigger finger splint 목적 : MP의장측아탈구를교정또는예방하기위해 MP의척측변위를막기위해 MP의 flexion을막거나가동역을제한하기위해 MP를고정하므로 IP에서 flexor digtorum superficialis와 profundus가능동적인굴곡을하기위해 적응증 : 관절염증, trigger finger, Dupuytren's 구축의외과적수술후, IP의능동적인굴곡이안될때, MP의 head의골절

29 Trigger finger, dupuytren s de. 굴곡건초의비후지절협착성건초염 장측건막의비후 MP,PIP 굴곡기형 신전이어렵다. 수동신전가능

30 Rheumatoid Arthritis

32 Circumferntial hand-base dynamic traction D2-5 MP corrective radial deviation orthosis Common Name: static ulnar drift/deviation splint 목적 : MP의척측변위를막기위해 MP의 flexion을막거나가동역을제한하기위해 적응증 : 관절염증 ( 류마치스성관절염등 )

33 static ulnar drift/deviation splint

34 static ulnar drift/deviation splint

35 Figure-eight hand-based static D4-5 MP extension-blocking orthosis Common Name: Static anticlaw deformity splint 목적 : 4,5 손가락의 MP의안정을위해 (MP의과신전을수정하고 MP의 collateral ligament의단축을예방하고 IP의능동적인신전을증진하기위해 ) 적응증 : Ulnar nerve lesion

36 Claw hand

37 Finger platform orthosis 목적및구성 : opponens orthosis 의 dorsal bar 에 platform splint attachment 를고정시켜서굴곡된손가락을신전상태로유지하기위한것이다. 이와비슷한역할을하는보조기는 hand sandwich 와 pancake splint 가있다.

38 Hand sandwich, pancake

39 IP orthosis Common Name: finger splint 목적및구성 : 손가락을신전상태로유지시키기위해서 1cm 넓이의편평한금속판을손목위에서부터시작하여한손가락의각관절위를지나손가락끝을감싸고손가락바닥쪽으로구부러져있다. 금속판끝은패드를대어서압박을견딜수있도록하며손목은스트랩으로고정한다.

40 Finger Extension orthosis

41 Circumferntial hand-base dynamic joint-alligned coilspring D2-5 MP assistive flexion and thumb assistiveopposition orthosis Common Name: spring wire knuckle bender / anticlaw deformity splint 목적 : MP의능동적신전을허용한상태에서 MP의수동적굴곡을하기위해 (MP의과신전을수정하고 MP의 collateral ligament의단축을예방하고 IP의능동적인신전을증진하기위해 ) 적응증 : median & ulnar nerve 의손상

42 hand deformity Median+Ulna Median Ulna Radial

43 1st dorsal interosseus assist little outrigger 를연결하여검지손가락의요골측편위를조절. 5th finger adduction splint 척골측을플라스틱이나가죽으로싸고새끼손가락의기절골에밴드와스프링으로연결하여새끼손가락이척골측편위가되는것을방지

$metacarpal fracture splint 목적 : 치유촉진을위한 MC의안정 적응증 : 3,4,5 MC 의 Midshaft$

45 Circumferential Nonarticular metacarpal-stabilizing orthosis Common Name: metacarpal fracture splint 목적 : 치유촉진을위한 MC의안정 적응증 : 3,4,5 MC 의 Midshaft 골절

46 Circumferential hand-based static MCP- PIP flexion blocking orthosis Common Name: Blocking splint 목적 : MP와 PIP을고정하므로 DIP의능동적인굴곡을만들기위해 적응증 : DIP의신전구축

47 Circumferential hand-based staticprogressive MERIT-Screw MP-IP flexion orthosis Common Name: final flexion splint 목적 : MP와 PIP의신전방향으로구축되었을때굴곡방향으로당겨서굴곡의가동역을증진 적응증 : extrinsic 신전건의구축

48 Circumferential hand-based dynamic tube-outrigger PIP Corrective-extension orthosis Common Name: Low profile dynamic PIP extension splint 목적 : PIP가굴곡방향으로구축되었을때신전방향으로당겨서신전의가동역을증진

49 Circumferential Nonarticular proximal phalanx-stabilizing orthosis Common Name: proximal phalanx fracture brace 목적 : 지절골의골절의안정을위해 적응증 : 지절골골절

50 Circumferential finger-based PIP-stabilizing buddy straps Common Name: buddy splint 목적 : 손상된쪽과손상되지않은쪽의 proximal, middle 지절골에 strap을감아서관절의편위나회전을예방하기위해, 손상되지않은쪽의움직임에의해수동적인움직임을손상된쪽에주기위해 적응증 : PIP 측부인대손상

51 buddy splint

53 Spiral finger-based static PIP extensionblocking orthosis Common Name: swan neck splint 목적 : PIP의과신전방지 적응증 : swan neck 기형 ( 류마치스관절염, PIP 활막염등으로인한 ) Trigger finger

56 swan neck MP,DIP-Flex PIP-Ex 류마토이드관절염, 외상

57 Three-point finger-based dynamic joint -aligned coil-spring PIP corrective Common Name: Capener splint 목적 : PIP의관절낭과인대의구축을신장시켜신전범위를늘리고단축된조직의성장을촉진하기위해, PIP의측부안정을위해 적응증 : PIP 굴곡구축, PIP dorsal dislocation, 측부인대의손상, Boutonniere 기형

58 Boutonniere 기형 MP,DIP-Ex PIP-Flex 류마토이드관절염, 외상

60 엄지손가락에대한보조기

61 Radial Forearm-Based Static Wrist-Thumb Orthosis Common Name: De Quervain's static splint 목적 : 건염이있는수근관절과엄지의 CMC and MCP joint의고정을위해 적응증 : De Quervain's 건활막염 ( 건초염 ), 제1 신근수근관의활액초안의 Abductor pollicis longus와 Extensor Policis brebis의건의염증

62 Volar Forearm-Based Static Wrist-Thumb Orthosis : (1) 과목적은동일하며 Scaphoid 골절이나 Bennett's 골절 - 탈구시에쓰인다.

64 Circumferential Thumb-based static thumb-mcp orthosis Common Name: Thumb splint 목적 : 엄지의 MP의통증경감이나염증치유를위한안정 적응증 : MP 염증, 손상, 류마치스성관절염으로인한불안정, 외상, 과용성장해 Gamekeeper's thumb, skier's thumb( 엄지의척측측부인대의염좌 )

65 Gamekeeper s

67 Circumferential Wrist-based dynamic thumb opposition strap Common Name: Thumb abduction splint 목적 : 엄지의 palmar abduction자세를취하기위해, 굴곡강직패턴을깨기위해 적응증 : thenar muscle의약화나마비 (median nerve palsy 등으로인한 ) CNS 손상으로인하여엄지의내전강직이있을때

PowerPoint 프레젠테이션

PowerPoint 프레젠테이션 Physical Examination of the Wrist & Hand 연부조직촉진 (soft tissue palpation) 연부조직의촉진 (soft tissue palpation) 1) 수근관절제 1구역 ; 요골경상돌기 (radial styloid process) (1) Anatomical snuffbox - 요측연 장모지외전근 (Abd. poll. long