Article

Retrospective study at a rehabilitation center. OBJECTIVES:
Patients with spinal cord injury, even if they are wheelchair users, sometimes
suffer from fractures of the lower limb bones. As their bones are too weak to
have surgery, and because a precise reduction is not required for restoration,
such patients are often indicated for conservative treatment. This case series
study investigated the use of a hinged, soft-plastic brace as a conservative
approach to treating fractures of the lower extremities of patients with spinal
cord injury. SETTING: National Rehabilitation Center, Japan. METHODS: Fifteen
patients (male, n=10; female, n=5; average age, 52.7 years) with 19 fractures of
the femur or the tibia who were treated with a newly-developed hinged,
soft-plastic brace were studied. All of them used wheelchairs. We analyzed the
time taken for fracture union and for wearing orthotics, degree of malalignment,
femorotibial angle and side effects. RESULTS: The fractures in this series were
caused by relatively low-energy impact. The average time taken for fracture union
was 80.1 (37-189) days, and the average amount of time spent wearing orthotics
was 77.9 (42-197) days. On final X-ray imaging, the average femorotibial angle
was 176.9 degrees (s.d. +/-8.90), and 15 degrees of misalignment in the sagittal
plane occurred in one patient. CONCLUSION: A hinged, soft-plastic brace is a
useful option as a conservative approach for treating fractures of the lower
extremities in patients with spinal cord injury.

Langue : ANGLAIS