| 关节松动术应用于老年桡骨远端骨折术后的临床疗效观察 |
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投稿时间：2017-04-12
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| 作者 | Author | 单位 | Address | E-Mail |
| 贾雪峰 |
JIA Xue-feng |
武义县第一人民医院, 浙江 武义 321200 |
The First People's Hospital of Wuyi, Wuyi 321200, Zhejiang, China |
zjwywd@163.com |
| 蔡宏歆 |
CAI Hong-xin |
浙江大学医学院附属邵逸夫医院, 浙江 杭州 310000 |
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| 林格生 |
LIN Ge-sheng |
武义县第一人民医院, 浙江 武义 321200 |
The First People's Hospital of Wuyi, Wuyi 321200, Zhejiang, China |
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| 方基石 |
FANG Ji-shi |
武义县第一人民医院, 浙江 武义 321200 |
The First People's Hospital of Wuyi, Wuyi 321200, Zhejiang, China |
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| 王勇 |
WANG Yong |
武义县第一人民医院, 浙江 武义 321200 |
The First People's Hospital of Wuyi, Wuyi 321200, Zhejiang, China |
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| 吴志勇 |
WU Zhi-yong |
武义县第一人民医院, 浙江 武义 321200 |
The First People's Hospital of Wuyi, Wuyi 321200, Zhejiang, China |
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| 涂旭辉 |
TU Xu-hui |
武义县第一人民医院, 浙江 武义 321200 |
The First People's Hospital of Wuyi, Wuyi 321200, Zhejiang, China |
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| 期刊信息：《中国骨伤》2017年，第30卷，第7期，第643-646页 |
| DOI：10.3969/j.issn.1003-0034.2017.07.012 |
| 基金项目: |
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中文摘要:
目的：探讨关节松动术对老年桡骨远端骨折术后患者腕关节功能、疼痛和握力的影响。
方法：自2015年1月至2016年6月共纳入符合标准的老年桡骨远端骨折患者67例，分为常规锻炼组和关节松动术组。其中常规锻炼组37例，采用常规桡骨远端骨折术后关节功能锻炼方案，男16例，女21例；平均年龄（67.8±3.2）岁（60~72岁）；优势侧23例，非优势侧14例；跌倒26例，车祸11例；AO分型：B3型6例，C1型18例，C2型7例，C3型6例。关节松动术组30例，在对照组基础上增加关节松动术治疗，男14例，女16例；平均年龄（67.1±4.0）岁（61~74岁）；优势侧21例，非优势侧9例；跌倒25例，车祸5例；AO分型：B3型8例，C1型13例，C2型6例，C3型3例。观察患者术后3个月腕关节的活动度、Gartland-Werley腕关节功能评分、VAS疼痛评分及握力。
结果：治疗3个月后，常规锻炼组腕关节VAS评分大于关节松动术组（P<0.05）。常规锻炼组和关节松动术组患侧握力均低于健侧，但关节松动术组患侧平均握力高于常规锻炼组（P<0.05）。常规锻炼组掌屈、背伸、桡偏平均角度均明显大于观察组（P<0.05），而常规锻炼组尺偏角度与关节松动术组差异无统计学意义（P>0.05）。治疗后Gartland-Werley各项评分比较中，两组患者在残余畸形、并发症中差异无统计学意义（P>0.05），常规锻炼组主观评分、客观评分、总分均明显高于关节松动术组（P<0.05）；常规锻炼组治疗后腕关节功能Gartland-Werley评分中优21例，良10例，可6例，关节松动术组中优23例，良6例，可1例，两组分布比较差异具有统计学意义（P<0.05）。
结论：老年桡骨远端骨折术后关节松动术的应用可以提高患者关节活动度，获得更好的腕关节功能。 |
| 【关键词】关节松动术 桡骨骨折 老年人 |
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| Clinical observation on the effect of joint mobilization in treating elderly patients after distal radius fractures operation |
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ABSTRACT
Objective: To investigate the effect of joint mobilization on postoperative wrist joint function,pain and grip strength for elderly patients with distal radius fracture.
Methods: From January 2015 to June 2016,a total of 67 elderly patients with distal radius fracture were randomly divided into routine exercise group and joint mobilization group. Among them,37 patients in the routine exercise group underwent conventional distal radius fracture postoperative joint function exercise regimen,including 16 males and 21 females with a mean age of (67.8±3.2) years old ranging from 60 to 72 years old;the injured side was dominant in 23 cases and non-dominant in 14 cases;injury mechanism was fall in 26 cases,traffic accident in 11 cases; for AO type,6 cases were type B3,18 cases were type C1,7 cases were type C2,6 cases was type C3. Other 30 patients in the joint mobilization group underwent joint mobilization on the basis of the routine exercise group including 14 males and 16 females with a mean age of (67.1±4.0) years old ranging from 61 to 74 years old; the injured side was dominant in 21 cases and non-dominant in 9 cases;injury mechanism was fall in 25 cases,traffic accident in 5 cases;for AO type,8 cases were type B3,13 cases were type C1,6 cases were type C2,9 cases were type C3. The wrist joint activity,Gartland-Werley wrist joint function score,VAS pain score and grip strength were observed at 3 months afrer treatment.
Results: After 3 months' treatment,the VAS in the routine exercise group was higher than that of the joint mobilization group (P<0.05). The grip strength of affected side in both groups were lower than that of contralateral side,but the average grip strength of affected side in joint mobilization group was higher than that in routine exercise group(P<0.05). In routine exercise group,the average angle of flexion,extension,radial deviation were significantly higher than those of joint mobilization group(P<0.05). But ulnar deviation angle in routine exercise group compared with joint mobilization group had no significant difference (P>0.05). In the comparison of each item of Gartland-Werley,there was no significant difference between two groups in residual deformity and complication(P>0.05); the average score of subjective score,objective score and total score in routine exercise group were significantly higher than those of the joint mobilization group (P<0.05). The wrist function Gartland-Werley score in routine exercise group after treatment was excellent in 21 cases,good in 10,6 in fair,while in joint mobilization group,excellent in 23,good in 6,fair in 1(P<0.05).
Conclusion: The application of joint mobilization in the treatment of elderly patients with distal radius fracture can improve the joint activity and obtain better wrist function after surgery. |
| KEY WORDS Joint mobilization Radius fractures Elderly |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 贾雪峰,蔡宏歆,林格生,方基石,王勇,吴志勇,涂旭辉.关节松动术应用于老年桡骨远端骨折术后的临床疗效观察[J].中国骨伤,2017,30(7):643~646 |
| 英文格式: | JIA Xue-feng,CAI Hong-xin,LIN Ge-sheng,FANG Ji-shi,WANG Yong,WU Zhi-yong,TU Xu-hui.Clinical observation on the effect of joint mobilization in treating elderly patients after distal radius fractures operation[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(7):643~646 |
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