Whining
In medicine, whining refers to the treatment of mobility-restricted joints using suitable aids . Typical aids are bandages , tensioners and screws. The whining bandage or apparatus exerts a permanent force on the affected joint in the direction of its restriction. It is crucial to dose the force so that the patient does not feel any pain.
Similarly, a bandage is also called a whisker bandage that develops an elastic tension parallel to the direction of movement of a tendon. This type of bandage is used for post-treatment of tendon injuries.
principle
The basic principle behind these aids is that tension is applied to the joint to counteract the direction of the contracture . The application of whining bandages is a medical service. The term Quengelverband is also found in the literature as a synonym for the dynamic splint, which is used for the follow-up treatment of tendon injuries . In these cases, however, the purpose of the pulling device is not to treat a joint contracture, but to relieve the surgically (re) adapted tendon .
Basically, one can differentiate between dynamic and static whining. Dynamic whining means the use of an elastic resistance (see above), static means a rigid fixation such as that used in clubfoot treatment . The term redression is usually used for the latter . used.
construction
A whelk bandage consists of two attachment options for a suitable pulling device placed proximally and distally of the joint requiring treatment. Hinged bandage sleeves (circular plaster casts, splints or leather sleeves) or, for example for the finger joints, a forearm splint (Quengel splint ) , supplemented by a holder on the fingernail, and springs or simple household rubbers as a pulling device are suitable as fastening options . Detachable devices with the same properties are also known as squeegees .
variants
In the case of whine splints, a distinction is made between static and dynamic whine splints.
In comparison to static squeezing, dynamic squeezing joints have the advantage of even force distribution. The desired goal can be reached faster with significantly less effort. This considerably reduces the risk of pressure points developing. Dynamic Quengel splints usually show an almost linear force development. This property contributes particularly to improving the mobility of the joints ; thus the better mobilization of spastic muscles is supported. These whistling splints are particularly used when spasms occur . Here they act as required against occurring contractures . When a spasm sets in, the orthotics work antagonistically, as they give in at the appropriate moment and do not counteract. Thus, the patient does not get into the spasm, but can live out his spasm. After the spasm has subsided, the joint is returned to its original position.
history
Historically, whining has been a form of treatment that has been known for centuries. The first Quengelschiene was described by Hans von Gersdorff around 1530 .
Individual evidence
- ^ W. Pschyrembel: Clinical dictionary. de Gruyter, 1977, ISBN 3-11-007018-9 .
- ^ Text of the annex List of fees for medical services
- ↑ K.-D. Thomann (Ed.): Orthopedic-Accident Surgery Assessment: Practice of clinical assessment. Urban & Fischer, 2008, ISBN 978-3-437-24860-3 , p. 218. ( Google books )
- ^ Dietrich Hohmann, Ralf Uhlig: Orthopädische Technik. Thieme, 2005, ISBN 3-13-135929-3 , p. 397. ( Google books ), with a representation of a quengel bar with buttonhole deformity
- ^ Hans-Peter Bischof, Jürgen Heisel, Hermann Locher: Practice of conservative orthopedics. Thieme, 2007, ISBN 978-3-13-142461-7 , p. 115. ( Google books )
- ^ Hans U. Debrunner, Wolfgang Rüdiger Hepp: Orthopädisches Diagnostikum. Thieme, 2004, ISBN 3-13-324007-2 , p. 4. ( Google books )
