桡腕中药熏洗及功能锻炼辅助腕关节镜下松解治疗桡骨远端骨折术关节僵硬对患者腕关节功能的影响

Effect of Fumigation and Functional Exercise of Traditional Chinese Medicine on Wrist Function for Patients with Distal Radius Fracture Treated with Wrist Arthroscopy

目的:观察桡骨远端骨折术后关节僵硬患者采用桡腕中药熏洗及功能锻炼辅助腕关节镜下松解治疗的临床效果。方法:选取我院收治的60例符合纳入要求的患者作为研究对象,采用随机数字表分为试验组和对照组各30例,对照组术中取出内固定物后不做其他特殊处理,试验组术中取出内固定物后在腕关节镜下行腕关节松解,两组患者均给予桡腕中药熏洗及功能锻炼;对比两组患者治疗前后不同时间点的关节功能变化。结果:在治疗前,试验组和对照组的腕关节疼痛、功能、活动范围、握力方面评分比较,差异均无统计学意义(P>0.05);治疗1个月后,试验组的腕关节活动范围、握力评分均高于对照组,差异具有统计学意义(P<0.05);试验组的疼痛、功能评分与对照组比较,差异无统计学意义(P>0.05);在治疗2个月后,试验组的腕关节疼痛、功能、活动范围、握力评分均高于对照组,差异具有统计学意义(P<0.05);在治疗4个月后,试验组的腕关节功能评分均高于对照组,差异具有统计学意义(P<0.05);试验组和对照组的腕关节疼痛、活动范围、握力评分比较,差异无统计学意义(P>0.05)。结论:桡骨远端骨折术后关节僵硬患者采用桡腕中药熏洗及功能锻炼联合腕关节镜下松解术对于腕关节功能恢复具有更好的临床效果。

Objective:To investigate the clinical effect of radiocarpal Chinese herb fumigation and functional exercise for patients with joint stiffness after distal radius fracture.Methods:Sixty patients in our hospital who met the requirements for inclusion were selected as the research objects.The random number table was used to divide them into an experimental group and a controlled group with 30 cases each.The controlled group did not perform other special treatment after the internal fixation was removed during the operation.After the internal fixation was taken out,the wrist joints were loosened under wrist arthroscopy.The two groups of patients were treated with traditional Chinese medicine fumigation and functional exercise of the hind wrist.The changes of joint function at different time points before and after treatment were compared between the two groups.Results:Before treatment,there was no significant difference in the scores of wrist pain,function,range of motion,and grip strength between the test group and the controlled group(P>0.05);after 1 month of treatment,the test group’s range of motion,the scores of grip strength were higher than those of the controlled group,and the difference was statistically significant(P<0.05);the pain and function scores of the test group were compared with those of the controlled group,and the difference was not statistically significant(P>0.05);after 2 months of treatment,the wrist pain,function,range of motion,and grip strength scores of the test group were higher than those of the controlled group,and the difference was statistically significant(P<0.05);after 4 months of treatment,the wrist function scores of the test group were higher than those of the controlled group,the difference was statistically significant(P<0.05);there was no significant difference in wrist pain,range of motion,and grip strength scores between the test group and the controlled group(P>0.05).Conclusion:Patients with joint stiffness after distal radius fracture have better clinical effect on wrist function recovery by fumigation and functional exercise combined with carpal arthroscopy.