摘要
目的 探索侧方入路关节松解术结合系统康复对外伤性掌指关节僵硬的疗效.方法 选取2022年7月至2023年7月于平阴县人民医院康复医学科就诊的120例外伤后掌指关节僵硬的患者,根据治疗方案的不同分为研究组(采取侧方入路关节松解术和系统康复,n=60)和对照组(采取常规康复,n=60).比较组间关节活动度、掌指功能、患掌握力、握力持续时间及指尖压力.结果 治疗前,两组患者主动关节活动度、被动关节活动度和上肢DASH评分均无显著差异(P＞0.05);治疗后,两组主动关节活动度和被动关节活动度明显增加(P＜0.001),且研究组活动度增加更显著(P＜0.001);治疗后,两组上肢DASH评分均降低(P＜0.001),且研究组降低更显著(P＜0.001).治疗前,两组患者握力、握力持续时间和指尖压力均无显著差异(P＞0.05);治疗后,两组患者握力、握力持续时间和指尖压力均明显增加(P＜0.001),但与对照组相比,研究组握力、握力持续时间及指尖压力增加程度均无显著差异(P＞0.05).结论 侧方入路关节松解术联合系统康复可显著改善患掌的关节活动度和掌指功能,有利于患者的恢复.
Abstract
Objective To explore the effect of lateral approach joint release combined with systematic re-habilitation on traumatic metacarpophalangeal joint stiffness.Methods From July 2022 to July 2023,120 patients with post-injury metacarpophalangeal stiffness were recruited from the Rehabilitation Department of Pingyin County People's Hospital.According to different treatment plans,they were divided into the study group(lateral approach joint release+systematic rehabilitation,n=60)and the control group(conventional rehabilitation,n=60 cases).Joint range of motion,metacarpophalangeal function,mastery,grip duration,and fingertip pressure were compared between two groups.Methods From July 2022 to July 2023,120 patients with post-injury metacarpophalangeal stiffness were recruited from the Rehabilitation Department of Pingyin County People's Hospital.According to different treatment plans,they were divided into the study group(lateral approach joint release+systematic rehabili-tation,n=60 cases)and the control group(conventional rehabilitation,n=60).Joint range of motion,metacarpophalangeal function,mastery,grip duration,and fingertip pressure were compared between two groups.Results Before treatment,there were no significant differences in active joint motion,passive joint motion,and upper limb DASH score be-tween the two groups(P＞0.05).After treatment,active joint motion in both groups increased(P＜0.001),and pas-sive joint motion in both groups increased more significantly(P＜0.001),while the active and passive joint motion of the study group increased more than those of the control group increased(P＜0.001).After treatment,upper limb DASH scores decreased in both groups(P＜0.001),and the reduction was more significant in the study group than in the control group(P＜0.001).Before treatment,there were no significant differences in grip strength,grip strength duration,and fingertip pressure between the two groups(P＞0.05).After treatment,grip strength,grip strength dura-tion,and fingertip pressure of both groups significantly increased(P＜0.001),but there were no significant dif-ferences in grip strength,grip strength duration,and fin-gertip pressure increase degree between the two groups(P＞0.05).Conclusion Lateral approach joint release combined with systematic rehabilitation can significantly improve the range of motion and metacarpal and digital function of the affected palm,which is conducive to the re-covery of patients.
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