筋骨理筋手法干预对股骨下段骨折术后患者膝关节功能康复的影响

Effect of Manipulation Intervention on Knee Joint Function of Patients wit Lower Femur Fracture after Operation

要目的:探讨筋骨理筋手法预对股骨下段骨折术后患者膝关节功能康复的影响。方法:选择我院2019年4月一2022年9月诊治的股骨下段骨折术后患者85例作为研究对象,根据1:1随机分配原则分为观察组(手法组)43例与对照组42例。对照组给予常规护理干预,观察组在对照组护理的基础上给予筋骨理筋手法干预,2组护理观察时间持续1个月,观察与记录所有患者膝关节功能恢复情况。结果:护理后观察组的总有效率为97.7%,对照组为85.7%,观察组与对照组对比有明显提高(P<0.05)。2组护理后的膝关节功能Lysholm评分明显高于护理前(P<0.05),疼痛VAS评分明显低于护理前(P<0.05),且护理后观察组的膝关节功能、疼痛VAS评分与对照组对比存在明显差异(P<0.05)。2组护理后的股外侧肌表面肌电中位频率与护理前对比明显降低(P<0.05),且护理后观察组的股外侧肌表面肌电中位频率都显著低于对照组(P<0.05)。2组护理后的膝关节内侧压痛阈值低于护理前(P<0.05),且护理后观察组的膝关节内侧压痛阈值与对照组对比也有显著降低(P<0.05)。观察组护理期间的括静脉血栓、切口感染、尿潴留、愈合不良等膝关节相关并发症发生率为2.3%,与对照组的19.0%相比有明显降低(P<0.05)。结论:筋骨理筋手法干预在股骨下段骨折术后康复患者的应用能促进膝关节功能的恢复,有利于缓解疼痛,改善患者的总体预后,还能降低股外侧肌表面肌电中位频率,提高膝关节内侧压痛阈值,减少并发症的发生。

Objective:To explore and analysis the effects of manipulation intervention of tendon and bone on the functional rehabilitation of knee joint in patients with lower femur fracture after operation.Methods:From April 2019 to September 2022,85 patients with distal femoral fractures treated in our hospital were selected as the research objects.According to the principle of 1:1 random allocation,they were divided into the manipulation group(43 cases)and the control group(42 cases).The control group was given routine nursing intervention,and the manipulation group was given muscle and bone manipulation intervention on the basis of the control group.The nursing observation lasted for one month,and the recovery of knee joint function of all patients was observed and recorded.Results:After nursing,the total effective rate was 97.7%in manipulation group and 85.7%in control group(P<0.05).Compared with before nursing,Lysholm score of knee function increased and pain VAS score decreased after nursing(P<0.05),and the degree of increase/decrease in manipulation group after nursing was more obvious than that in control group(P<0.05).The median frequency of surface electromyography of lateral femoral muscle after care was lower than that before care in both groups(P<0.05),and the median frequency of surface electromyography of lateral femoral muscle in manipulation group after care was lower than that in control group(P<0.05).The tenderness threshold of medial knee joint in the two groups after nursing was lower than that before nursing(P<0.05),and the tenderness threshold of medial knee joint in the manipulation group after nursing was significantly lower than that in the control group(P<0.05).The incidence of knee joint related complications such as parenteral vein thrombosis,incision infection,urinary retention and poor healing was 2.3%in the manipulation group,which was lower than 19.0%in the control group(P<0.05).Conclusion:The application of the manipulation of tendon and bone in the rehabilitation of patients with lower femoral fracture afer operation can promote the recovery of knee joint function,help to relieve pain,improve the overall prognosis of patients,reduce the median frequency of the surface electromyography of the lateral femoral muscle,increase the tenderness threshold of the medial knee joint,and reduce the occurrence of complications.