Clinical outcomes and mechanism of Pingle Zhenggu(平乐正骨)gently-pushing&sliding-on-skin manipulation for treatment of early swelling and pain after the ankle fracture surgery
Objective:To observe the clinical outcomes and safety of Pingle Zhenggu(平乐正骨,PLZG)gently-pushing&sliding-on-skin manipulation for treatment of early swelling and pain after the surgery of ankle fracture,and to explore its underlying mechanism.Methods:Sixty-eight patients who just underwent surgery for ankle fracture were selected and randomized into manipulation group and con-trol group,34 ones in each group.All patients in the 2 groups were treated with the conventional treatment including drug therapy,physical therapy and rehabilitation exercises;while the ones in manipulation group were further treated with PLZG gently-pushing&sliding-on-skin manipulation.All patients were treated from the first day after enrollment for consecutive 7 days.The affected ankle pain visual analogue scale(V AS)score,ankle swelling value,ankle active range of motion(ROM),and the levels of interleukin-6(IL-6),C-reactive protein(CRP),plasma fibrinogen(FIB)and D-dimer in peripheral blood were compared between the 2 groups.Furthermore,the complications,such as incision infection and re-displacement of the fractured end,in the 2 groups were observed and recorded.Results:The affected ankle pain VAS score was lower,the ankle swelling value was smaller,and the ankle active ROM was greater after the end of the treatment com-pared to pre-treatment(4.81±1.98 vs 2.46±0.71 points,t=33.496,P=0.000;4.92±1.81 vs 2.97±0.82 points,t=30.207,P=0.000;14.87±5.12 vs 8.02±2.78 mm,t=27.532,P=0.000;15.11±6.67 vs 9.45±3.02 mm,t=23.114,P=0.000;20.17±5.23 vs 32.76±8.18 degrees,t=16.893,P=0.000;18.92±6.12 vs 28.45±7.64 degrees,t=15.622,P=0.000);and the affected ankle pain VAS score was lower,the ankle swelling value was smaller,and the affected ankle active ROM was greater in manipulation group com-pared to control group(t=2.742,P=0.008;t=2.031,P=0.046;t=2.245,P=0.028).The levels of 1L-6,CRP,plasma FIB and D-di-mer in peripheral blood decreased in the 2 groups after the end of the treatment compared to pre-treatment(7.11±0.78 vs 5.59±0.49 pg/mL,t=43.453,P=0.000;7.43±0.82 vs 6.01±0.58 pg/mL,t=40.369,P=0.000;12.07±4.11 vs 8.18±2.92 mg/L,t=22.164,P=0.000;12.41±4.45 vs 9.87±3.01 mg/L,t=20.628,P=0.000;5.14±1.09 vs 2.07±0.31 pg/L,t=32.723,P=0.000;5.21±1.22 vs 2.61±0.82 pg/L,t=28.129,P=0.000;2.34±0.79 vs 1.05±0.26 mg/L,t=25.601,P=0.000;2.56±0.87 vs 1.28±0.34 mg/L,t=21.114,P=0.000),and they were lower in manipulation group compared to control group(t=3.225,P=0.002;t=2.350,P=0.022;t=3.592,P=0.001;t=3.133,P=0.003).No patients in the 2 groups suffered from complications,such as incision infection and re-displacement of the fractured end.Conclusion:PLZG gently-pushing&sliding-on-skin manipulation can effectively relieve joint pain,alleviate joint swelling,and improve joint ROM in treatment of early swelling and pain followed the surgery of ankle fracture,and it exhibits high safety.It may exert the effects by reducing the levels of IL-6,CRP,plasma FIB and D-dimer in peripheral blood.
ankle fracturespain,postoperativeswellingtui na therapy
NETL
NSTL
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