小针刀配合手法松解治疗肱骨近端骨折术后肩关节粘连的临床观察

Clinical Observation on Small Needle Knife Combined with Manipulative Release in the Treatment of Postoperative Shoulder Joint Adhesion after Proximal Humeral Fracture

目的研究小针刀配合手法松解治疗肱骨近端骨折术后肩关节粘连的临床效果。方法选取我院2017年2月—2018年2月收治的肱骨近端骨折术后肩关节粘连患者40例作为研究对象,随机将40例患者分为2组,各20例,观察组患者采用小针刀配合手法松解,对照组则采用臂丛麻醉下肩关节手法松解,对患者治疗前、治疗3个月后的肩关节功能与疼痛程度进行评估。结果治疗前,2组患者的ASES评分、VAS评分、UCLA评分差异无统计学意义(P>0.05);治疗3个月后,观察组患者的ASES评分高于对照组,VAS评分低于对照组,UCLA评分高于对照组,差异均有统计学意义,(P<0.05)。治疗3个月后,观察组总有效率为95%,对照组总有效率为70%,观察组高于对照组,差异存在统计学意义,(P<0.05)。结论肱骨近端骨折术后肩关节粘连应用小针刀配合手法松解具有良好治疗效果,值得推广。

Objective To study the clinical effect of small needle knife combined with manipulative release in the treatment of postoperative shoulder joint adhesion after proximal humeral fracture. Methods 40 cases of shoulder joint adhesion in the proximal humerus fracture treated in our hospital from February 2017 to February 2018 were selected as the subjects. According to the random voluntary principle, 40 patients were divided into two groups, with 20 cases in each group. The patients in the observation group were loosened with small needle knife and manipulation, and the control group was loosely manipulated under the brachial plexus anaesthesia. The function and pain degree of shoulder joint were evaluated before and 3 months after treatment. Results Before treatment, the ASES score, VAS score and UCLA score of the two groups had no statistical difference P〉0.05. After 3 months of treatment, the ASES score of the patients in the observation group was higher than the control group, the VAS score in the observation group was lower than in the control group, and the UCLA score in the observation group was higher than in the control group, and the difference was statistically significant between the groups P〈0.05. After 3 months of contrast treatment, the clinical efficacy of the observation group was 95%, the total effective rate of the control group was 70%, and the observation group was higher than the control group. The difference of data between the groups was statistically significant P〈0.05. Conclusion The application of small needle knife combined with manipulative release has a good therapeutic effect on shoulder joint adhesion after proximal humeral fracture surgery. It is worth popularizing.