弹拨手法结合小夹板固定对小儿拇指狭窄性腱鞘炎的影响

Effect of Plucking Technique Combined with Small Splint Fixation on Thumb Stenosing Tenosynovitis in Children

目的探讨弹拨手法结合小夹板固定对小儿拇指狭窄性腱鞘炎的影响。方法选取2016年1月—2019年4月该院推拿门诊及骨科门诊收治的80例小儿拇指狭窄性腱鞘炎患者,采用随机数字表法将其分为常规组(40例)和研究组(40例),常规组采用常规治疗,研究组采用以弹拨手法结合小夹板固定治疗,两组均治疗8周。观察两组临床疗效,治疗前后腱鞘厚度以及视觉模拟评分(VAS)。结果研究组总有效率为95.00%(38/40),高于常规组的80.00%(32/40)(P <0.05);治疗后,两组腱鞘厚度均降低,且研究组低于常规组(P <0.05);治疗后,两组完成抓物、夹筷子、拧瓶盖时的VAS评分均降低,且研究组均低于常规组(P <0.05);经相关性分析发现,腱鞘厚度与抓物、夹筷子、拧瓶盖时VAS评分均呈正相关(P <0.05)。结论弹拨手法为主结合小夹板固定治疗小儿拇指狭窄性腱鞘炎疗效显著,能够明显促进患儿拇指生理屈伸功能恢复正常,缓解患儿疼痛症状。

Objective To investigate the effect of plucking technique combined with small splint fixation on thumb stenosing tenosynovitis in children.Methods A total of 80 patients with stenotic tenosynovitis in children who were admitted to our hospital between January 2016 and April 2019 were enrolled in the outpatient clinic and orthopedic clinic.They were divided into the regular group( 40 cases) and the study group( 40 cases) by random number method.The regular group was treated with conventional therapy,and the study group was treated with plucking method combined with small splint fixation.Both groups were treated for 8 weeks.The clinical efficacy in the two groups,tendon sheath thickness before and after treatment and visual analog scale( VAS)were observed.Results The total effective rate in the study group was 95.00%( 38/40),which was higher than that in the regulargroup( 80%.00,32/40)( P < 0.05).After treatment,the thickness of the tendon sheath decreased in both groups,and the thickness of the tendon sheath of grasping,chopsticks and screw capsin the study group was lower than that in the regular group( P <0.05).After treatment,the scores of VAS in the two groups of patients were reduced and that of the study group was lower than that ofthe regular group( P < 0.05).Correlation analysis showed that the tendon sheath thickness and the scores of VAS of grasping,chopsticks and screw caps were positively correlated( P < 0.05).Conclusion The plucking method is mainly combined with small splint fixation for the treatment of children with thumb tenosytenitis.The curative effect is remarkable,which can significantly promote the normal function of the thumb flexion and extension of children and relieve the pain symptoms.