Redressal

Redressal is violent correction of deformity or vicious provisions of locomotor apparatus, mainly legs. Redressal is one of the methods of orthopedic treatment. In the basis of Redressal is the stretching of tissues or squeeze them with the restoration of the axis or configuration this part of the body.
Indications for Redressal - connective tissue ankylosis, incorrectly non-Union fractures with the curvature axis, contractures, congenital clubfoot, arthrogryposis, muscular torticollis and other deformations. Used Redressal in children's practice is more often, as in children tissue is more elastic and supple. Redressal produce metered power taking into account elastic resistance of the tissues, not moving within their fortress under General anesthesia or without it, depending on the type of deformation and age of the patient.
There are two types of Redressal - manual and instrumental (with the help of various devices and apparatus-regrestore). Instrumental Redressal rougher and currently has limited application. Manual Redressal less traumatic, more accessible and in some cases (congenital clubfoot, muscular torticollis and others) can be performed paramedical personnel.
When manually Redressal hands firmly grasp located above and below the parts of the limbs and, acting as their arm, make careful short but strong tremors or stretching and compression in the opposite curvature side approximately 3-5 minutes Tissue under the action of these efforts are stretched, is achieved fix some perverse situation. To save the achieved results impose fixing plaster bandage for 1-2 weeks, depending on the type of deformation and age of the patient. If you completely eliminate the deformation of one-stage failed, after removal of plaster bandages again produce Redressal and again impose a plaster bandage. Step Redressal repeat until, until you will be removed perverse situation. The number of sessions depends on the type and degree of deformation. Insufficient stretching of tissues and the failure of fixing plaster bandage can lead to relapse.
During Redressal and after imposition of fixing the plaster bandage is necessary to monitor the state of the tissue, paying particular attention to the circulation. Cyanosis, swelling, violation of the sensitivity of demand to change bandages and decrease the amount of correction. Dangerous rough attempts single Redressal, especially under General anesthesia. They can cause damage to large vessels and nerves, to the rupture of ligaments or muscles to bone fractures.

Redressal (from France. redresser - straighten - operation violent, bloodless, without disturbing the integrity of the skin, correction of deformation, the vicious situation, pathological installations limbs and other parts of the musculoskeletal apparatus.
If Redressal produce violent formation of tissues by mechanical impact: stretching the soft tissues on a concave, short side and compression convex, elongated. The force of impact when Redressal measured with the degree of elasticity of tissues. Elasticity (elasticity of tissues prevents the change of the form repressirovannogo body, but once she got over and the distance between the molecules of the body exceeded the so-called radius molecular impact, given the situation, modification, in varying degrees, maintained even after the termination of force.
Further violence may entail a violation of adhesion molecules up to break the tissues. In such cases speak about forced Redressal. Modeling call Redressal in which crossed only the elasticity limit, but not the limit of the fortress tissues. Redressal shown for contractures the different etiology, when connective ankylosis, the curvature of the bones after diseases and as a result of fusion of napravlennyh of fragments (in the stage of primary bone spur). In childhood could fix even the inveterate curvatures, but to do it it is necessary to resort to artificial softening of the bones (with drugs). Most often Redressal used in the treatment of congenital clubfoot, Krivoshei, arthrosis, scoliosis, with deformation in the palsy (spastic and sluggish), rachitic curvature, etc Redressal can be independent and auxiliary medical method before or supplementing the bloody operation (for example, when changing the muscles, while lengthening the Achilles tendon and other). When performing single-Redressal inexperienced hands, possible complications include damage to blood vessels, nerves (restretching, breaks them), entailing circulatory disorders, trophic. You may experience extensive interstitial bruises, fractures, soft tissue, bone fractures. Possible outbreak of infection as a consequence of violence in the joints, which previously had the inflammatory process. Tissue swelling caused by gross regresaria, can cause compression of the legs plaster cast, which is usually impose after Redressal. Rarely such complications occur when you commit repressirovannih soft tissues bandage or bus. If time does not eliminate excessive compression, expressed by the pallor or cyanosis distal extremities, loss of tactile sensitivity can cause gangrene. In order to prevent injury from excessive violence (especially in the high stiffness of tissues) often resort to a gradual correction of deformity - a few steps (2-4-6 and more sessions) - stage Redressal.


Equipment Redressal: 1 - wedge; 2 - Board with hinge; 3 - lever Thomas.

The technique of Redressal. The operator tightly grasps the hands of the patient's body distal and proximal to deformation; then lower part, as the lever, produces a jerky movement in the opposite curvature, and some time keeps limb(or other body part) in the corrected position. Then releases it. Described manipulations repeat a few times, then fix limb in the position given to it by dressing for the term of 2 to 6 to 8 weeks. When staging Redressal terms of fixing and accordingly the breaks between the sessions are 5-10 days. The bandage can not completely remove; this allows you to save the bandages and, above all, to prevent the loss reached at the previous stage of correction; quite a buzz cut the old plaster cast on the level of distortion and excise the wedge in the entire thickness of the shells on the long side of her. After another Redressal bandage close, with the effort of bringing together its edges, and strengthen several rounds fresh plaster bandage.
To make Redressal use different devices, arranged on the principle of the lever or screw (large and small wedges Koenig, regrestore Turner, table Schulze, lever Thomas, boards with hinges and other) (Fig., 1-3). Redressal in children are well could just manually with a small relaxation of muscles.
Redressal should be performed under General anesthesia, after the usual preoperative preparation of the patient. Sometimes you can successfully hold R. under local anesthesia, including under intraosseous anesthesia.