动静平衡原则对小儿肱骨髁上骨折术后关节功能恢复的影响

Effect of dynamic-static equilibrium principle on postoperative recovery of joint function in children with supracondylar fracture of humerus

目的探讨动静平衡原则对小儿肱骨髁上骨折术后关节功能恢复的影响。方法选择2015年2月~2016年8月上海中医药大学附属曙光医院收治的肱骨髁上骨折患儿72例,均实施切开复位经皮克氏针固定术治疗。将所有患儿根据随机数字表法分为两组,每组各36例。实验组根据动静平衡原则实施功能康复锻炼,对照组根据传统功能康复原则实施功能锻炼。记录两组患儿骨折功能康复时间、肘关节屈伸活动角度、术后2周疼痛程度[视觉模拟评分法(VAS)、儿童疼痛行为量表(FLACC)]、术后12周肘关节功能康复情况以及并发症发生情况。结果实验组中骨折功能康复时间显著短于对照组,肘关节屈伸活动角度大于对照组,差异有高度统计学意义(P<0.01);实验组中肘关节功能康复优良率为97.22%(35/36)显著高于对照组的80.56%(29/36),差异有统计学意义(P<0.05);术后2周实验组VAS、FLACC评分均低于对照组,差异有高度统计学意义(P<0.01);对照组并发症发生率高于实验组,但比较差异无统计学意义(P>0.05)。结论对小儿肱骨髁上骨折术后根据动静平衡原则实施功能锻炼,能有效缩短骨折功能康复时间、促进肘关节功能康复,增大肘关节屈伸活动角度,降低患者术后疼痛程度,减少并发症发生,安全性较高。

Objective To investigate the effect of dynamic-static equilibrium principle on postoperative recovery of joint function in children with supracondylar fracture of humerus （SFH）. Methods 72 SFH children in our hospital from February 2015 to August 2016 were selected, and they were treated with open reduction and percutaneous Kirschner internal fixation. All the children were divided into two groups by random number table, 36 cases in each group. Experimental group was given functional rehabilitation based on dynamic-static equilibrium principle, while control group was given functional rehabilitation based on traditional rehabilitation principle. The rehabilitation time of fracture, flexion-extension angle of elbow joint, postoperative two-week pain degree [visual analogue scale score （VAS）, the face, legs, activity, cry, consolability behavioral tool （FLACC）], postoperative twelve-week rehabilitation of elbow joint, complications in two groups were recorded. Results The rehabilitation time of fracture in experimental group was shorter than control group, while the flexion-extension angle of elbow joint was larger than control group, the differences were statistically significant （P 〈 0.01）; the excellent rate of rehabilitation of elbow joint in experimental group was 97.22% （35/36）, which was higher than 80.56% （29/36） in control group, the differences were statistically significant （P 〈 0.05）; after surgery for two weeks, the scores of VAS, FLACC in experimental group were lower than control group, the differences were statistically significant （P 〈 0.01）; the incidence of complications in control group was higher than that in experimental group, but there was no statistical difference （P 〉 0.05）. Conclusion Functional exercise based on dynamic-static equilibrium principle for SFH children can shorten the rehabilitation time of fracture, promote recovery of elbow joint, enlarge the flexion-extension angle of elbow joint, decrease postoperative pain, reduce complications and have higher safety.