综合功能训练在极重度创伤后肘关节僵硬患者康复中的应用效果

Application effect of comprehensive function training in the rehabilitation of extremely severe patients with posttraumatic elbow stiffness

目的探讨综合功能训练在极重度创伤后肘关节僵硬患者康复中的应用效果。方法收集河北省秦皇岛市第一医院2014年9月～2015年9月择期行手术治疗的患者共计98例，按照随机数字表法将其随机分为干预组及传统组，每组各49例，患者采用开放松解术联合铰链式外固定支架进行治疗。传统组给予常规康复训练，干预组在传统组干预的基础上给予综合功能训练，包括肱尺关节活动、肱桡关节活动、桡尺关节松动、功能训练，记录伸屈角度的改善及Mayo肘关节功能评分，同时对随访中干预组的典型病例进行分析。结果两组伸直角度、屈曲角度、肘关节平均屈伸活动度及Mayo肘关节功能评分干预前后比较，差异均有统计学意义（P〈0．05或P〈0．01）．且干预组干预后伸直角度、屈曲角度、肘关节平均屈伸活动度及Mayo肘关节功能评分较传统组改善更为明显，差异有统计学意义（P〈0．05）。干预组干预后肘关节功能优良率显著高于传统组，差异有统计学意义（P〈0．05）。结论采用综合功能训练对于极重度创伤后肘关节僵硬患者而言，能够明显改善其伸屈角度，提高肘关节功能评分，稳定性良好，值得推广应用。

Objective To study the application effect of comprehensive function training in the rehabilitation of ex- tremely severe patients with posttraumatic elbow stiffness. Methods Ninety eight cases undergoing elective surgical treatment were collected from September 2014 to September 2015 in the First Hospital of Qinhuangdao and randomly divided into intervention group and traditional group by random number table method, with 49 cases in each group, they were treated by open relaxation solution technique combined hinged external fixator for treatment. Traditional group was given routine rehabilitation training, intervention group was given the comprehensive function on the basis of conventional intervention training, including the humerus feet joint, humerus oar joint activities, radial ulnar joint loose- ness, function training. The improvement of the flex point and Mayo elbow function score were recorded, at the same time, typical cases follow-up in intervention group was analyzed. Results Comparison of two groups of unbend, buck- ling, the average elbow flexion mobility Mayo elbow joint function score before and after the intervention, the differ- ences were statistically significant （P 〈 0.05 or P 〈 0.01）. Intervention group after intervention was more apparent than traditional group in unbend, buckling, the average elbow flexion mobility Mayo elbow function score improvement, the differences were statistically significant （P 〈 0.05）. The excellent and good rate of elbow joint function in the interven- tion group was higher than that of traditional group, the difference was statistically significant （P 〈 0.05）. Conclusion The comprehensive functional training for patients with extremely severe posttraumatic elbow joint stiffness can signifi- cantly improve the flex point of view, improve the elbow joint function score, stability is good, which is worthy of popu- larization and application.