tailieunhanh - Chữa bệnh xương

Trong hai thập kỷ qua, một số thể thức vật lý đã được phê duyệt cho việc quản lý của công đoàn bị trì hoãn và nonunique. Cấy trực tiếp hiện tại kích thích hiệu quả trong việc quản lý IS thành lập chi nonunique của năm và như tá dược trong phản ứng tổng hợp đạt được cột sống. | Use of Physical Forces in Bone Healing Fred R. T. Nelson MD Carl T. Brighton MD PhD James Ryaby PhD Bruce J. Simon PhD Jason H. Nielson MD Dean G. Lorich MD Mark Bolander MD PhD and John Seelig MD Abstract During the past two decades a number of physical modalities have been approved for the management of nonunions and delayed unions. Implantable direct current stimulation is effective in managing established nonunions of the extremities and as an adjuvant in achieving spinal fusion. Pulsed electromagnetic elds and capacitive coupling induce elds through the soft tissue resultingin low-magnitude voltage and currents at the fracture site. Pulsed electromagnetic elds may be as effective as surgery in managing extremity nonunions. Capacitive coupling appears to be effective both in extremity nonunions and lumbar fusions. Low-intensity ultrasound has been used to speed normal fracture healing and manage delayed unions. It has recently been approved for the management of nonunions. Despite the different mechanisms for stimulating bone healing all signals result in increased intracellular calcium thereby leading to bone formation. J Am Acad Orthop Surg 2003 11 344-354 Nonunion has been defined as no demonstrated change in healing on serial radiographs over a 3-month Delayed union is defined as a speed of fracture healing that is slower than anticipated with no implied expectancy of either eventual healing or eventual nonunion. Of approximately 6 million extremity fractures that occur annually in the United States 2 3 between 5 and 10 result in either nonunion or delayed Assuming an average cost in lost wages and additional medical treatment for each of these cases of 10 000 the annual economic loss is 3 to 6 billion. In an attempt to minimize problems with fracture healing improved methods of internal and external fracture immobilization have been combined with appropriately timed early transmission of physiologic forces across the fracture .