慢性関節リウマチ患者における人工肘関節置換術後の一症例
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- ふじよし たかにし
- 5 years ago
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1 KEY WORDS RA TEA (MD) 1 (MD) 1 (MD) RA Steinbrocker stageclass TEA Darrach 7.5 PROM-T (P) 30(P) 30 20(P) 45 0 MMT JOA Active 5 Passive 6 ROM-T JOA 66 ADL TEA 5 Passive 3
2 Judet MD 1) Judet Bipolar Judet Mason ROM JOA score ROM JOA score Judet Judet 7 ROM JOA score 92
3 1) 1) 1) 1) 1) (MD) 2) (MD) 1) (MD) 1) (MD) 1) Key words Zuggurtungs Zuggurtungs ( Zug Zug 80 Colton group2 Gustilo type Zug 90 MMT : : ADL Zug 125Zug 7
4 Quadrilatelaral space syndrome 1) 1) 1) 1) 1) 2) 1) 2) quadrilatelaral space syndrome( QLSS) 24 H16 5 Backhand Stroke follow through QLS 3 spasm QLSS rotator interval hyperlaxity Backhand Stroke follow through QLSS hyperlaxity overuse phase QLS hyperlaxity tightness Backhand Stroke follow through hyperlaxity tightness form
5 10 AO Dynamic Condylar Pate K-wire MRSA extension lag 10 X-P AO Gustilo -C debridment
6 (MD) (MD) (MD)2) (MD)2) key words,,,.,, PT cm (AO 52kg H ,. :A1),. (+)., :C3) (AO 8 26,, (+),VAS:3/10.ROM, 5, 0., 5, 2 2., :33.0cm/38.5cm, +5cm:35.5cm/39.0cm, :33.0cm/40.0cm. PT 1 PT. 3 Knee Brace,PT. 4 ROM 90,SLR. 4,ROMex. 6 ROM 125, lag10 11, 135, 4-, lag5,t., 3 PT,,,. PT,.
7 MD MD ROM PT PT PT ROM ROM ROM PT ROM
8 MD MD key words Zuggurtung Zuggurtung part 6 30 Zuggurtung knee brace MMT MMT knee brace 75 lag lag PT patella setting part Zuggurtung
9 Zuggurtungs (MD) (MD) key words Zuggurtungs. Zuggurtungs ( Zug ) 5. 6 Zug ( : parts 4 3parts 1 ) ( ) CKC Zug..Zug (OKC CKC) amplitude lag.
10 1) 1) (MD) 1) 1) Dr 14 4/ amplitude excursion 11 MMT extension lag amplitude extension lag 23 MRI 9 extension lag extension lag 9
11 MD MD MD KEY WORDS,.,,,. 14,, K-wire..7 11,.7 23 K-wire. 1/ PT..,...ROM-T MMT 3 3,4. footprint,mtp.,,.,.,.3,.,,, over use.,,,,.,,,,.,3,.
12 MD Esse x Lopresti Tongue type Graffin X P Graffin Graffin / Graffin
13 MD MD MD KEY WORDS EPL EPL 7 IP MPCM IP / 60 /65 70/80 MP 54/54-4/10 IP 70/70 15/25 IP 4 Buck-Gramcko exellent TAM tension IP elongation
14 Kleinert ) ) ) ) ) ) ) ) ) ) ) ) ) KEY WORDS Kleinert Kleinert extrinsic healing intrinsic healing (Zone ) FDP (Zone) FDP (Zone) FDP Pulley A A ex. ( MP IP )RBT(rubber band traction) TAM () () () () () () PIPDIP pulley
15 Colles Dynamic splint MD 2) MD 2) 1) 2) 3) Colles splint snow board 3 2 plate 4 12 ROM X-P plate buttress effect ROM X-P plate buttress effect 5 1 grove splint 5 11 Dynamic splint 5 15 ROM Colello splint 8 7 ROM supple joint splint X-P RSL stretching wrist splint splint ROM
16
17 knee in toe out NITO KITO KITO Newham Sjostrom Stauber
18
19 infra-patella 2 3 a b c cm 5 14
20 (ACL) (ACL) MCL) 35 MCLACL PCL (MM) 4 MCL 3 7 gyps patella patella stretch gyps 28 gyps cutacl 1/2 ROM 0 90 ()MM () anterior drower()posterior drower() 42 ROM MCLACL MCL ACL MCL ACLPCL MCL gyps patella gyps 90
21 ACL ACL MCL ACL MCL ACL MCL ACL MCL ACL MCL ACL 6 1 ACL ACL ACL 0 Lag 0 145MMT ACL 6 0 Lag 0 145MMT Lag 0 155MMT MCL MCL MCL ACL ACL ACL
22 PF ( VL A-P extensibility ) OA grade (++) (+) (-) GSP ST 44.2% VL APextensibility 23.0% 77.0% 23.0%75.3% 1.7% OA grade :25 :55 :29 :4 FTA %41.8% A-Pextensibility 41.4% 10.4% (+)58.6% 89.6% 41.4%10.4% (+)56.5% 88.0 (-)2.1% 1.6% OA grade grade:2 :19 :21 :2 grade:23 :36 :8 : %8 61.1% PF PF OA grade 12 6 grade 12 9
23
24 ROM PT PT PT 5 ROM PT 1 5 PT ROM PT PT 5 AO ROM PT PT P ROM PT 5 PT
25 PCL lift off PF PCL 27 AO typedepression-wedge type 2mm depression 5 11
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