中医四联疗法促进儿童肱骨髁上骨折术后功能康复
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摘要
目的:探讨中医四联疗法对儿童肱骨髁上骨折术后功能康复的临床疗效。方法:选择2017年1月至2018年1月在广州市正骨医院骨伤五区行手术治疗的儿童肱骨髁上骨折的患儿共60例,随机分为实验组及对照组,各30例,实验组患者去除石膏后给予中医四联疗法进行功能锻炼;对照组患者拆除石膏后进行常规关节松动训练;采用Flynn评定标准,收集两组患者患肢功能恢复时间、并发症发生率。结果:实验组优良率为90. 0%,优于对照组的73. 3%;实验组SF-36量表评分(88. 2±4. 52)分,高于对照组的(72. 1±7. 53)分;实验组治疗后的并发症发生率10. 00%,低于对照组的30. 00%;实验组患者骨折愈合时间(77. 00±5. 99)d,短于对照组的(87. 03±4. 47)d;差异均有统计学意义(P<0. 05)。结论:中医四联疗法能有效促进儿童肱骨髁上骨折术后肘关节功能的恢复,缩短康复周期,减少不良事件的发生率,改善治疗满意度。
Objective: To explore the clinical effect of quadruple therapy of traditional Chinese medicine on functional rehabilitation of children with supracondylar fracture of humerus.Methods: Sixty children with supracondylar fracture of humerus were randomly divided into treatment group and control group, with 30 cases in each group. The patients in the treatment group were given functional exercise with quadruple therapy of traditional Chinese medicine after removal of plaster. Routine joint loos-ening training and Flynn criteria were used to collect the recovery time of limb function and the incidence of complications.Results: The excellent and good rate of the experimental group was 90. 0%,which was better than 73. 3% of the control group; the score of SF-36 in the experimental group was(88. 2±4. 52), which was higher than that of the control group(72. 1±7. 53); the incidence of compli-cations in the experimental group was 10. 00%, which was lower than that of the control group(30. 00%); the healing time of fracture in the experimental group was shorter than that of the control group, as(77. 00 ± 5. 99) d vs(87. 03 ± 4. 47) d(P<0. 05).Conclusion: TCM quadruple therapy can effectively promote the recovery of elbow joint function, shorten the rehabilitation cycle, reduce the incidence of adverse events, and improve the treatment satisfaction of children with supracondylar fracture of humerus.
Objective: To explore the clinical effect of quadruple therapy of traditional Chinese medicine on functional rehabilitation of children with supracondylar fracture of humerus.Methods: Sixty children with supracondylar fracture of humerus were randomly divided into treatment group and control group, with 30 cases in each group. The patients in the treatment group were given functional exercise with quadruple therapy of traditional Chinese medicine after removal of plaster. Routine joint loos-ening training and Flynn criteria were used to collect the recovery time of limb function and the incidence of complications.Results: The excellent and good rate of the experimental group was 90. 0%,which was better than 73. 3% of the control group; the score of SF-36 in the experimental group was(88. 2±4. 52), which was higher than that of the control group(72. 1±7. 53); the incidence of compli-cations in the experimental group was 10. 00%, which was lower than that of the control group(30. 00%); the healing time of fracture in the experimental group was shorter than that of the control group, as(77. 00 ± 5. 99) d vs(87. 03 ± 4. 47) d(P<0. 05).Conclusion: TCM quadruple therapy can effectively promote the recovery of elbow joint function, shorten the rehabilitation cycle, reduce the incidence of adverse events, and improve the treatment satisfaction of children with supracondylar fracture of humerus.
引文
[1] Davalos MA, Gallucci G, Alfie V, et al. Dynamic splint for the treatment of stiff elbow[J]. Journal of Hand Therapy, 2010,23(4):e14-e15.
[2] Wagner M. General principles for the clinical use of the LCP[J]. Injury,2013,34(2):31-42.
[3] Nandi S, Maschke S, Evans PJ, et al. The stiff elbow[J]. Hand, 2009,4(4):368-379.
[4]诸苏杭,许晓跃,方育科.中医手法联合中药熏洗治疗儿童肱骨髁上骨折术后肘关节功能恢复临床观察[J].新中医,2017,49(2):75-77.Zhu SH, Xu XY, Fang Y. Clinical observation of el-bow joint function recovery after supracondylar fracture of humerus in children treated by traditional Chinese medicine manipulation combined with fumigation and washing with Chinese medicine[J]. Journal of New Chi-nese Medicine, 2017,49(2):75-77.
[5]刘茜,王银凤,李海涛.儿童肘部骨折所致肘关节功能障碍康复治疗[J].中国医药科学,2011,1(23):107-121.Liu X, Wang YF, Li HT. Rehabilitation treatment of elbow joint dysfunction caused by elbow fracture in chil-dren[J]. China Medicine and Pharmacy, 2011, 1(23):107-121.
[6] Keskin D, Sen H. The comparative evaluation of treat-ment outcomes in pediatric displaced supracondylar hu-merus fractures managed with either open or closed re-ductionand percutaneous pinning[J]. Acta Chir Orthop Traumatol Cech, 2014,81(6):380-386.
[7]张彦,马长生,杨泽晋,等.平乐郭氏手法复位半交叉钢针固定治疗儿童肱骨髁上骨折的临床观察[J].中国骨与关节损伤杂志,2015,30(5):533-534.Zhang Y, Ma CS, Yang ZJ, et al. Clinical observation of Pingle Guo′s manipulative reduction and semi-cross steel needle fixation for the treatment of supracondylar fracture of humerus in children[J]. Chinese Journal of Bone and Joint Injury, 2015,30(5):533-534.
[8]马长生,苏驰.手法整复与经皮钢针内固定治疗儿童GartlandⅢ型肱骨髁上骨折1 100例[J].临床小儿外科杂志, 2015,14(3):231-233.Ma CS, Su C. Manual reduction and percutaneous steel needle internal fixation for 1 100 children with Gartland typeⅢsupracondylar fracture of humerus[J].Journal of Clinical Pediatric Surgery, 2015, 14(3):231-233.
[9]康宇翔,卫小春,李海明.闭合复位石膏托固定加石膏外牵引治疗儿童肱骨髁上骨折的病例对照研究[J].中国骨伤,2014,27(7):555-559.Kang YX, Wei XC, Li HM. A case-control study of closed reduction and plaster bracket fixation plus plaster external traction for the treatment of supracondylar frac-ture of humerus in children[J]. China Journal of Ortho-paedics and Traumatology, 2014,27(7):555-559.
[10]水小龙,张建军,孔建中,等.急诊手法复位石膏固定后延期经皮克氏针固定治疗儿童Ⅲ型肱骨髁上骨折[J].中华小儿外科杂志,2014,35(3):208-211.Shui XL, Zhang JJ, Kong JZ, et al. Emergency manu-al reduction and gypsum fixation delayed percutaneous Kirschner Needle fixation for children with Type III su-pracondylar fracture of humerus[J]. Chinese Journal of Pediatric Surgery, 2014,35(3):208-211.
[11] Park MJ, Ho CA, Larson AN. AAOS appropriate use criteria:Management of pediatric supracondylar humer-us fractures[J]. J Am Acad Orthop Surg,2015,23(10):e52-e55.
[12]吴文英,钱定金,许蓉,等.游戏式功能锻炼在儿童肱骨髁上骨折康复锻炼中的应用[J].中国康复,2014,29(2):113-114.Wu WY, Qian DJ, Xu R, et al. The application of game-based functional exercises in rehabilitation exercis-es for children with humeral supracondylar fracture[J].Chinese Journal of Rehabilitation, 2014,29(2):113-114.
[2] Wagner M. General principles for the clinical use of the LCP[J]. Injury,2013,34(2):31-42.
[3] Nandi S, Maschke S, Evans PJ, et al. The stiff elbow[J]. Hand, 2009,4(4):368-379.
[4]诸苏杭,许晓跃,方育科.中医手法联合中药熏洗治疗儿童肱骨髁上骨折术后肘关节功能恢复临床观察[J].新中医,2017,49(2):75-77.Zhu SH, Xu XY, Fang Y. Clinical observation of el-bow joint function recovery after supracondylar fracture of humerus in children treated by traditional Chinese medicine manipulation combined with fumigation and washing with Chinese medicine[J]. Journal of New Chi-nese Medicine, 2017,49(2):75-77.
[5]刘茜,王银凤,李海涛.儿童肘部骨折所致肘关节功能障碍康复治疗[J].中国医药科学,2011,1(23):107-121.Liu X, Wang YF, Li HT. Rehabilitation treatment of elbow joint dysfunction caused by elbow fracture in chil-dren[J]. China Medicine and Pharmacy, 2011, 1(23):107-121.
[6] Keskin D, Sen H. The comparative evaluation of treat-ment outcomes in pediatric displaced supracondylar hu-merus fractures managed with either open or closed re-ductionand percutaneous pinning[J]. Acta Chir Orthop Traumatol Cech, 2014,81(6):380-386.
[7]张彦,马长生,杨泽晋,等.平乐郭氏手法复位半交叉钢针固定治疗儿童肱骨髁上骨折的临床观察[J].中国骨与关节损伤杂志,2015,30(5):533-534.Zhang Y, Ma CS, Yang ZJ, et al. Clinical observation of Pingle Guo′s manipulative reduction and semi-cross steel needle fixation for the treatment of supracondylar fracture of humerus in children[J]. Chinese Journal of Bone and Joint Injury, 2015,30(5):533-534.
[8]马长生,苏驰.手法整复与经皮钢针内固定治疗儿童GartlandⅢ型肱骨髁上骨折1 100例[J].临床小儿外科杂志, 2015,14(3):231-233.Ma CS, Su C. Manual reduction and percutaneous steel needle internal fixation for 1 100 children with Gartland typeⅢsupracondylar fracture of humerus[J].Journal of Clinical Pediatric Surgery, 2015, 14(3):231-233.
[9]康宇翔,卫小春,李海明.闭合复位石膏托固定加石膏外牵引治疗儿童肱骨髁上骨折的病例对照研究[J].中国骨伤,2014,27(7):555-559.Kang YX, Wei XC, Li HM. A case-control study of closed reduction and plaster bracket fixation plus plaster external traction for the treatment of supracondylar frac-ture of humerus in children[J]. China Journal of Ortho-paedics and Traumatology, 2014,27(7):555-559.
[10]水小龙,张建军,孔建中,等.急诊手法复位石膏固定后延期经皮克氏针固定治疗儿童Ⅲ型肱骨髁上骨折[J].中华小儿外科杂志,2014,35(3):208-211.Shui XL, Zhang JJ, Kong JZ, et al. Emergency manu-al reduction and gypsum fixation delayed percutaneous Kirschner Needle fixation for children with Type III su-pracondylar fracture of humerus[J]. Chinese Journal of Pediatric Surgery, 2014,35(3):208-211.
[11] Park MJ, Ho CA, Larson AN. AAOS appropriate use criteria:Management of pediatric supracondylar humer-us fractures[J]. J Am Acad Orthop Surg,2015,23(10):e52-e55.
[12]吴文英,钱定金,许蓉,等.游戏式功能锻炼在儿童肱骨髁上骨折康复锻炼中的应用[J].中国康复,2014,29(2):113-114.Wu WY, Qian DJ, Xu R, et al. The application of game-based functional exercises in rehabilitation exercis-es for children with humeral supracondylar fracture[J].Chinese Journal of Rehabilitation, 2014,29(2):113-114.