传统关节粘连松解术结合腕手部作业治疗对桡远骨折致腕手僵硬康复疗效的初步观察

发布时间：2018-03-03 08:54

本文选题：桡远骨折　切入点：腕手功能障碍　出处：《成都体育学院》2017年硕士论文　论文类型：学位论文

【摘要】：目的:研究传统关节松解术结合作业治疗是否对桡骨远端骨折患者腕手功能障碍康复更有效。方法:本研究收集62例四川省骨科医院康复科住院女性患者,将患者分为两组,其中治疗组(传统关节粘连松解术结合腕手徒手训练)31例,试验组(传统关节粘连松解术结合腕手部作业治疗)31例。两组基线资料(年龄,病程,部位)基本一致,治疗前无差异。两组分别于治疗前,治疗两周后,治疗四周后测量指标。包括关节活动度、握力、腕手关节功能评分、Barthel指数评分、VAS评分。对搜集的指标进行观察分析。结果:1、治疗两周后,两组腕关节活动度无显著差异(p0.05),试验组指间关节活动度优于治疗组(p0.05);治疗四周后,两组腕关节活动度无显著差异(p0.05),试验组指间关节活动度改善优于治疗组(p0.05)。各组治疗前后均有显著差异。2、治疗两周后,两组握力无显著差异(p0.05);治疗四周后,治疗组握力优于试验组握力(p0.05)。各组治疗前后均有显著差异。3、治疗两周后,两组腕手关节功能评分无显著差异(p0.05);治疗四周后,试验组腕关节功能评分优于治疗组(p0.05)。各组治疗前后均有显著性差异。4、治疗两周后,试验组VAS评分小于治疗组VAS评分(p0.05);治疗四周后,两组VAS评分无显著差异(p0.05)。各组治疗前后均有显著差异。5、治疗两周与治疗四周时,两组Barthel指数评分无显著差异(p0.05)。各组治疗前后均有显著差异。结论:1、传统关节粘连松解术结合作业治疗在改善精细活动度和增加腕手灵活性方面,优于传统关节粘连松解术结合腕手徒手功能训练。2、传统关节粘连松解术结合徒手功能训练对于腕手肌力的恢复,优于传统关节粘连松解术结合作业治疗。3、传统关节粘连松解术结合作业治疗与传统关节粘连松解术结合腕手徒手功能训练对于改善腕关节活动度的作用一致。对于桡骨远端骨折导致的腕手功能障碍都有确切治疗效果。
[Abstract]:Objective: to study whether traditional arthrolysis combined with occupational therapy is more effective for rehabilitation of wrist and hand dysfunction in patients with distal radius fracture. Methods: 62 female patients in rehabilitation department of Sichuan Orthopaedic Hospital were collected and divided into two groups. Among them, 31 cases were treated in the treatment group (traditional joint adhesion release combined with free hand training) and 31 cases in the experimental group (traditional joint adhesion release combined with wrist operation). The baseline data (age, course of disease, site) of the two groups were basically the same. There was no difference between the two groups before treatment, two weeks after treatment, and four weeks after treatment. The functional score of wrist and hand joint and the score of Barthel index and VAS were observed and analyzed. Results: after two weeks of treatment, there was no significant difference in the motion of wrist joint between the two groups (p 0.05), and the activity of interphalangeal joint in the test group was better than that in the treatment group (P 0.05), and after four weeks of treatment, the movement of interphalangeal joint in the experimental group was better than that in the treatment group. There was no significant difference in wrist motion between the two groups (p 0.05). The improvement of interphalangeal motion in the experimental group was better than that in the treatment group. There was significant difference between the two groups before and after treatment. After two weeks of treatment, there was no significant difference in grip strength between the two groups, and after four weeks of treatment, there was no significant difference in grip strength between the two groups. The grip strength of the treatment group was better than that of the experimental group. There was significant difference before and after treatment. After two weeks of treatment, there was no significant difference in the score of wrist and hand joint function between the two groups, and after four weeks of treatment, there was no significant difference between the two groups in the score of wrist and hand joint function. The wrist function score in the experimental group was better than that in the treatment group (P 0.05). There was significant difference between the two groups before and after treatment. After two weeks of treatment, the VAS score in the test group was smaller than that in the treatment group (P 0.05), and after four weeks of treatment, the score of VAS in the experimental group was lower than that in the treatment group. There was no significant difference in VAS score between the two groups (p0.05). There was significant difference between the two groups before and after treatment. There was no significant difference in Barthel index score between the two groups (p 0.05). There were significant differences between the two groups before and after treatment. Conclusion: the traditional joint adhesion release combined with occupational therapy can improve the precision of motion and increase the flexibility of wrist and hand. It is superior to the traditional joint adhesion release combined with the wrist hand function training. 2. The traditional joint adhesion release combined with the free hand function training can restore the muscle strength of the wrist and hand. It is better than traditional joint adhesion release combined with occupational therapy. The effect of traditional joint adhesion release combined with traditional joint adhesion release combined with carpal hand free hand function training on improving wrist motion is the same as that of traditional joint adhesion release combined with occupational therapy. All of the wrist and hand dysfunction caused by distal radius fracture have definite therapeutic effect.
【学位授予单位】：成都体育学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R683

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