PubMed · 14090227
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S HARALDSSON. 1963-09-18. [FLATFOOT].. https://pubmed.ncbi.nlm.nih.gov/14090227/
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AIM: To report on the result of a fast-track referral service in treating deformational auricular anomalies using moulding therapy, by employing nurses who were familiar with the indications and technique, working in close liaison with plastic surgeons. METHODS: A deformational auricular anomaly is defined as an ear having normal chondrocutaneous components but an abnormal architecture; therefore, it can be manipulated digitally to a normal shape. Having demonstrated the value of auricular moulding therapy to our neonatal practitioners, we established a fast-track referral and treatment protocol for infants with deformational auricular anomalies. Treatment was initiated promptly by one of four nurses. The type and severity of the auricular anomaly were documented both clinically and photographically before and three months following cessation of treatment. Assessment of the results was made by comparing the pre- and post-treatment photographs and by a postal questionnaire, which was dispatched to the parents of the patients three months after treatment was discontinued. RESULTS: Sixteen male and 14 female patients, aged between one day and 15 weeks (mean 24 days) with 44 deformational auricular anomalies, underwent moulding therapy. Complete correction or marked improvement was achieved in 26 patients (87%) with 38 ears (86%) while slight or no improvement occurred in 4 patients (6 ears), following one to 14 (mean 7) weeks of moulding. Questionnaires were returned by the parents of 24 patients (80%). According to the parents' assessment, complete correction or marked improvement occurred in 29 of 35 anomalous ears (83%) in 20 of these 24 patients (83%). All parents felt that auricular moulding was worthwhile. CONCLUSIONS: Deformational auricular anomalies should be treated non-surgically with moulding therapy. For this treatment to be effective, it should be initiated in the first three months of life. Parental persistence with the treatment is essential for a satisfactory outcome. A fast-track referral service, employing nurses who form the first point of contact and work in close association with a plastic surgery service, is an effective treatment strategy that will largely negate the need for surgical correction of deformational auricular anomalies.
A venous leg ulcer is a sign of severe chronic venous insufficiency (CVI). Treatment is focused on the cause of CVI and on wound management. The basis of the treatment consists of compression therapy and sufficient exercise (walking). With this, 70% of the ulcers are healed after three months. Surgery is indicated when the venous insufficiency is the result of reflux in the superficial veins. Subfascial endoscopic perforator surgery can be considered in case of insufficient perforator veins but the long-term efficacy has not yet been established. Modern wound management with hydrocolloids, foams or alginates is satisfactory and well tolerated. When the ulcer has healed but the cause of the venous insufficiency cannot be corrected, life-long compression therapy with a flat-knitted therapeutic elastic stocking is necessary to prevent recurrences.
OBJECTIVES: To test the hypotheses that therapeutic taping of the knee improves pain and disability in patients with osteoarthritis of the knee and that benefits remain after stopping treatment. DESIGN: Randomised single blind controlled trial with three intervention arms (therapeutic tape, control tape, and no tape) of three weeks' duration and three week follow up. SETTING: Outcome assessment was performed in a university based laboratory. Taping interventions were applied by eight physiotherapists in metropolitan private practice. PARTICIPANTS: 87 patients with symptoms of knee osteoarthritis as defined by the American College of Rheumatology. MAIN OUTCOME MEASURES: Primary outcome measure was pain as measured by visual analogue scale and participant perceived rating of change. Secondary measures of pain and disability included the Western Ontario and MacMaster Universities osteoarthritis index, knee pain scale, and the SF-36. RESULTS: The therapeutic tape group reported a greater reduction in pain on all primary outcomes than either of the other two groups. A significant association was evident between intervention and change in pain at three weeks (P=0.000), with 73% (21/29) of the therapeutic tape group reporting improvement compared with 49% (14/29) of the control tape group and 10% (3/29) of the no tape group. Significantly greater improvement in pain and disability was observed on most secondary outcomes in the therapeutic tape group compared with the no tape group. Benefits of therapeutic tape were maintained three weeks after stopping treatment. CONCLUSIONS: Therapeutic knee taping is an efficacious treatment for the management of pain and disability in patients with knee osteoarthritis.