Ortoze pri sindromu karpalnega kanala : diplomsko delo

Letič, Tina (avtor), Lampe, Tomaž (mentor)

Uvod: Sindrom karpalnega kanala spada v kategorijo kroničnih skeletno-mišičnih okvar, ki nastanejo zaradi preobremenitve kitnih ovojnic in zapestja. Imenujemo ga tudi sindrom čezmerne obremenjenosti. Predstavlja skupek znakov in simptomov, ki so rezultat utesnitve središčnega živca znotraj karpalnega kanala. Zdravimo ga lahko kirurško in nekirurško. Nekirurško zdravljenje je z ortozami, steroidno zdravljenje in ultrazvočno zdravljenje. Kirurško zdravljenje je odprtje karpalnega kanala in sprostitev živca in endoskopsko sproščanje živca v karpalnem kanalu. Za izdelavo ortoz najpogosteje uporabimo termoplastične materiale z nizko temperaturo. Materiali so nizkotemperaturni če je njihova temperatura obdelave med 57°in 82°C. Namen: Namen seminarske naloge je predstaviti anatomijo zapestja, predstaviti sindrom karpalnega kanala in zdravljenje karpalnega kanala z ortozami. Zastavila sem si vprašanje ali so ortoze z metakarpofalangelano enoto boljše v primerjavi z nevtralnimi ortozami za zapestje pri zdravljenju sindroma karpalnega kanala. Metode dela: V seminarski nalogi sem uporabila diskriptivno metodo dela, pregled že obstoječe literature s področja zapestja in karpalnega kanala. Literaturo sem iskala med knjigami in internetnimi članki. Pomagala sem si s spletnimi bazami ScienceDirect, Medline, PubMed, Google učenjak in Cobiss. Članki in knjige so bili v večini v angleškem jeziku nekaj pa je bilo tudi v slovenskem jeziku. Osredotočila sem se na iskanje ortoz z MCP enoto ter nevtralnimi ortozami za zapestje. Rezultati: Primerjali so dve različni ortozi za zapestje. Navadno ortozo za zapestje in ortozo z metakarpofalangealno enoto. Pri dveh študijah je polovica pacientov zraven ortoz vsak dan izvajala še drsne vaje. Razprava in zaključek: Pri navadni ortozi je bilo zapestje v ničelnem položaju, pri ortozi z metakarpofalangealno enoto pa je bil kot v zapestju in kot metakarpofalangealnih sklepov v rahli fleksiji. Ortoza z metakarpofalangealno enoto je pokazala boljše rezultate pri zmanjšanju simptomov, bolečini in funkcijskem stanju v primerjavi z navadno ortozo. Čeprav je tudi navadna ortoza pokazala izboljšanje simptomov, bolečine in funkcionalnega stanja roke. Drsne vaje pa niso vplivale na izboljšanje. Glavni učinek je, da začnemo nositi ortoze v treh mesecih po pojavitvi simptomov in, da jih nosimo redno.

• Jezik: Slovenski jezik
• Ključne besede: anatomija karpalnega kanala, sindrom karpalnega kanala, ortoze za zapestje, ortoza z MCP enoto, nevtralna ortoza
• Vrsta gradiva: Diplomsko delo/naloga
• Organizacija: ZF - Zdravstvena fakulteta
• Leto izida: 2019
• PID: 20.500.12556/RUL-107425
• COBISS.SI-ID: 5604971
• Datum objave v RUL: 12.04.2019

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: Brace carpal tunnel syndrome : diploma work

Izvleček

Introduction: Carpal tunnel syndrome belongs to the category of chronic skeletal-muscle damage caused by overloading of the envelopes and wrists. It is also called the syndrome excessive burden. It represents a set of signs and symptoms that are the result of a medial nervous compression within the carpal tunnel. We can treat it surgically and non-surgical. Non-surgical treatment is with orthoses, steroid therapy and ultrasound treatment. Surgical treatment is the opening of the carpal tunnel and the release of the nerve and the endoscopic release of the nerve in the carpal tunnel. For making orthosis is the most commonly used thermoplastic materials with low temperature. The materials are low temperature if their processing temperature is between 57 ° and 82 ° C.Purpose: The purpose of the seminar is to present the anatomy of the wrist, the carpal tunnel syndrome and treat the carpal tunnel with orthoses. I asked myself whether the orthoses with the metacarpofalangeale unit are better compared to neutral wrist orthoses in the treatment of carpal tunnel syndrome.Methods:In my graduation thesis, I used the discretionary method of work, a review of already existing literature of the wrist and carpal tunnel. I searched literature from books and internet articles. I helped my sey with ScienceDirect, Medline, PubMed, Google Scholar and Cobiss. Articles and books were mostly in english and some were also in slovene language. I focused on finding orthosis with metacarpophalangeal units and neutral wrist orthoses. Results: They compared two different orthosis for the wrist. Normal orthoses for wrists and orthoses with a metacaprophalangeal unit. In two studies, half of the patients performed sliding exercises next to the orthoses every day. Discussion and conclusion: At the neutral orthosis, the wrist was in a neutral position, and in the orthosis with the metacarpofalangeal unit, it was in a slight flexion, both in the wrist and in the metacarpofalangeal joints. Orthosis with the metacarpalphalangeal unit showed better results in reducing symptoms, pain and functional state compared to normal orthosis. Although regular orthosis has also shown an improvement in the symptoms, pain and functional state of the hand. However, gliding exercises did not affect the improvement. The main effect is that we begin to carry orthosis three months after the onset of symptoms were showed and that we wear them regularly.

• Ključne besede: anatomy carpal tunnel, carpal tunnel syndrome, orthoses for wrist, wrist splint with metacarpophalangeal unit, neutral wrist splint