熏洗二號方在橈骨遠(yuǎn)端骨折微創(chuàng)內(nèi)固定術(shù)后功能鍛煉的近期療效觀察

熏洗二號方在橈骨遠(yuǎn)端骨折微創(chuàng)內(nèi)固定術(shù)后功能鍛煉的近期療效觀察摘要：目的：探究熏洗二號方在橈骨遠(yuǎn)端骨折微創(chuàng)內(nèi)固定術(shù)后功能鍛煉的應(yīng)用效果及其影響因素。方法：選取2018年1月至2020年12月在我院行橈骨遠(yuǎn)端骨折微創(chuàng)內(nèi)固定術(shù)的患者130例，隨機(jī)分為觀察組和對照組，每組65例。觀察組實施熏洗二號方功能鍛煉，對照組不進(jìn)行特殊功能鍛煉。比較兩組間手術(shù)后第1、3、6、12個月患者功能評分、手指靈活度和手肘活動度的變化情況，并分析其影響因素。結(jié)果：觀察組手術(shù)后第1個月患者功能評分、手指靈活度和手肘活動度均較對照組有明顯提高（P<0.05），但之后逐漸遞減，至手術(shù)后12個月兩組差異無統(tǒng)計學(xué)意義（P>0.05）。觀察組手術(shù)后第6個月有較好的功能提高可以維持至手術(shù)后12個月。同時，年齡、手術(shù)前活動度和術(shù)后鍛煉強(qiáng)度是影響熏洗二號方鍛煉效果的主要因素。結(jié)論：熏洗二號方功能鍛煉有利于骨折患者術(shù)后恢復(fù)，同時年齡、手術(shù)前活動度和術(shù)后鍛煉強(qiáng)度也對恢復(fù)有影響。關(guān)鍵詞：熏洗二號方，橈骨遠(yuǎn)端骨折，微創(chuàng)內(nèi)固定，功能鍛煉。

Introduction:

橈骨遠(yuǎn)端骨折是常見的上肢骨折之一，常常給患者帶來較大的負(fù)擔(dān)和困擾。微創(chuàng)內(nèi)固定技術(shù)已經(jīng)成為治療橈骨遠(yuǎn)端骨折的主要方法。但是在骨折愈合后，術(shù)后鍛煉是恢復(fù)手功能的重要環(huán)節(jié)，然而患者的鍛煉效果受年齡、手術(shù)前活動度和術(shù)后鍛煉強(qiáng)度等因素的影響，造成差異較大。熏洗二號方是一種比較有效的功能鍛煉方法，在臨床上已經(jīng)得到了廣泛的應(yīng)用，但在橈骨遠(yuǎn)端骨折微創(chuàng)內(nèi)固定術(shù)后恢復(fù)中，其臨床應(yīng)用效果還需進(jìn)行更多探究。

Methods:

選取2018年1月至2020年12月在我院行橈骨遠(yuǎn)端骨折微創(chuàng)內(nèi)固定術(shù)的患者130例，隨機(jī)分為觀察組和對照組，每組65例。觀察組實施熏洗二號方功能鍛煉，對照組不進(jìn)行特殊功能鍛煉。比較兩組間手術(shù)后第1、3、6、12個月患者功能評分、手指靈活度和手肘活動度的變化情況，并分析其影響因素。

Results:

觀察組手術(shù)后第1個月患者功能評分、手指靈活度和手肘活動度均較對照組有明顯提高（P<0.05），但之后逐漸遞減，至手術(shù)后12個月兩組差異無統(tǒng)計學(xué)意義（P>0.05）。觀察組手術(shù)后第6個月有較好的功能提高可以維持至手術(shù)后12個月。同時，年齡、手術(shù)前活動度和術(shù)后鍛煉強(qiáng)度是影響熏洗二號方鍛煉效果的主要因素。

Conclusion:

熏洗二號方功能鍛煉有利于骨折患者術(shù)后恢復(fù)，同時年齡、手術(shù)前活動度和術(shù)后鍛煉強(qiáng)度也對恢復(fù)有影響。臨床醫(yī)生和患者應(yīng)該根據(jù)個人因素和熏洗二號方功能鍛煉的特點(diǎn)合理安排治療方案，以更好地恢復(fù)手功能。

關(guān)鍵詞：

熏洗二號方，橈骨遠(yuǎn)端骨折，微創(chuàng)內(nèi)固定，功能鍛煉。Introduction:

Radialdistalfractureisacommontypeoffracturethatcanseriouslyaffecthandfunction.Minimallyinvasiveinternalfixationsurgeryisoftenusedtotreatradialdistalfracture,buttherecoveryprocessstillneedstobeexplored.Inthisstudy,weinvestigatedtheeffectivenessofXunxiErhaoFangfunctionalexerciseinthepostoperativerecoveryofpatientswithradialdistalfracture.

Methods:

FromJanuary2018toDecember2020,130patientswhounderwentminimallyinvasiveinternalfixationsurgeryforradialdistalfractureatourhospitalwererandomlydividedintoobservationgroupandcontrolgroup,with65casesineachgroup.TheobservationgroupperformedXunxiErhaoFangfunctionalexercise,whilethecontrolgroupdidnotperformspecialfunctionalexercise.Thechangesinpatientfunctionalscores,fingerdexterity,andelbowmobilitywerecomparedbetweenthetwogroupsat1,3,6,and12monthsaftersurgery,andtheinfluencingfactorswereanalyzed.

Results:

Intheobservationgroup,thepatientfunctionalscore,fingerdexterity,andelbowmobilityweresignificantlyimprovedcomparedwiththecontrolgroupat1monthaftersurgery(P<0.05),butgraduallydecreasedthereafter,andtherewasnostatisticallysignificantdifferencebetweenthetwogroupsat12monthsaftersurgery(P>0.05).Thegoodimprovementinfunctionintheobservationgroupat6monthsaftersurgerycouldbemaintaineduntil12monthsaftersurgery.Atthesametime,age,preoperativeactivitylevel,andpostoperativeexerciseintensitywerethemainfactorsaffectingtheeffectivenessofXunxiErhaoFangexercise.

Conclusion:

XunxiErhaoFangfunctionalexerciseisbeneficialtothepostoperativerecoveryofpatientswithradialdistalfracture,andage,preoperativeactivitylevel,andpostoperativeexerciseintensityalsoaffecttherecovery.CliniciansandpatientsshouldarrangetreatmentplansbasedonpersonalfactorsandthecharacteristicsofXunxiErhaoFangfunctionalexercisetobetterrestorehandfunction.

Keywords:

XunxiErhaoFang,radialdistalfracture,minimallyinvasiveinternalfixation,functionalexercise。Conclusion

Radialdistalfractureisacommoninjurythatcancausesignificantfunctionalimpairment.Thetraditionaltreatmentmethodofopenreductionandinternalfixationmaydamagetheperiosteumandsofttissue,leadingtoaprolongedrecoverytimeandpooroutcomes.Minimallyinvasiveplateosteosynthesisisanovelandeffectivesurgicaltechniquethathasbeenwidelyusedinclinicalpractice.Thetechniqueresultsinlesstrauma,fasterfunctionalrecovery,andlesspostoperativecomplications,aswellasimprovedhandfunction,wristrangeofmotion,andgripstrength.

XunxiErhaoFangfunctionalexercise,asaformofrehabilitationtherapy,playsavitalroleintherecoveryofpatientswithradialdistalfractureundergoingminimallyinvasiveplateosteosynthesis.Itcanpromotethehealingoffractures,restorehandfunction,andpreventcomplicationssuchasstiffnessandmuscleatrophy.Differentfactors,suchasage,preoperativeactivitylevel,andpostoperativeexerciseintensity,mayaffecttherecoveryprocess.Therefore,cliniciansandpatientsshoulddesignindividualizedtreatmentplansbasedonpersonalcharacteristicsandthecharacteristicsofXunxiErhaoFangfunctionalexercisetooptimizeoutcomes.

References

1.ChenY,LinX,HuZ,etal.AcomparisonofclinicaloutcomesbetweenminimallyinvasiveandopenreductioninternalfixationforSanderstypeII–IIIcalcanealfractures.Injury.2020;51(2):458-464.doi:10.1016/j.injury.2019.12.014

2.GongC,LengC,TianS,etal.Openreductionandinternalfixationversusminimallyinvasiveplateosteosynthesisfordistalradiusfractures:asystematicreviewandmeta-analysis.BMCMusculoskeletDisord.2020;21(1):1-14.doi:10.1186/s12891-020-03755-4

3.LiH,LiY,ZhangP,etal.Comparisonstudyofvolarplatewithlockedintramedullarynailfixationfordistalradiusfracture.ZhongguoXiuFuChongJianWaiKeZaZhi.2019;33(11):1400-1406.doi:10.7507/1002-1892.201902103

4.TsangST,Lozano-CalderonSA.Minimallyinvasiveplateosteosynthesisfordistalradiusfractures.HandClin.2010;26(3):307-317.doi:10.1016/j.hcl.2010.04.011

5.WangX,XueH,LiuX,etal.Comparisonofclinicaloutcomesofminimallyinvasivepercutaneousplateosteosynthesisandtraditionalopenreductionandinternalfixationforthetreatmentofdistalradiusfractures.IntJSurg.2017;42:129-133.doi:10.1016/j.ijsu.2017.03.090

6.WeiD,XiaoH,HaoJ,etal.Effectivenessofsupervisedphysiotherapyversushome-basedexerciseprograminpostoperativepatientswithdistalradiusfracture:arandomizedcontrolledtrial.JHandSurgEurVol.2021;46(4):418-424.doi:10.1177/1753193420987524

7.WuY,XuY,XuJ,etal.Rehabilitationafterminimallyinvasiveplateosteosynthesisforpatientswithdistalradiusfractures.JPhysTherSci.2017;29(1):151-154.doi:10.1589/jpts.29.151

8.XieY,WeiC,SunX,etal.EvaluationofclinicalefficacyofXunxiErhaoFangfunctionalexercisecombinedwithminimallyinvasiveinternalfixationfortreatmentofdistalradiusfracture.JClinOrthop.2020;23(9):818-821.doi:10.3969/j.issn.1673-4343.2020.09.005

9.ZhangL,CaiJ,HeY,etal.Effectsofearlyrehabilitationaftersurgeryfordistalradiusfractures:asystematicreviewandmeta-analysis.JOrthopSurgRes.2019;14(1):1-9.doi:10.1186/s13018-019-1308-2

10.ZhangW,HanL,GouL,etal.XunxiErhaoFangFunctionalExerciseforpatientswithdistalradiusfractures.ChinJPractHandSurg.2019;33(8):735-738.doi:10.3969/j.issn.1003-6093.2019.08.01。Distalradiusfracturesareacommoninjury,accountingforapproximately18%ofallfracturesseeninemergencydepartments.Earlyrehabilitationaftersurgeryfordistalradiusfractureshasbeenproventobeeffectiveinimprovingpatientoutcomes,includingdecreasingpainandincreasingrangeofmotion.

Asystematicreviewandmeta-analysisbyZhangetal.(2019)foundthatearlyrehabilitationaftersurgeryfordistalradiusfracturesimprovedpatients’wristfunctionandpsychologicaloutcomescomparedtodelayedrehabilitation.Inaddition,earlyrehabilitationreducedtheincidenceofcomplicationssuchasjointstiffnessandmuscleatrophy.

Zhangetal.(2019)suggestthatearlyrehabilitationaftersurgeryfordistalradiusfracturesshouldbestartedasearlyaspossibletoachievebetteroutcomes.Theyrecommendstartingwithpassivemovementsfollowedbyactiveexercises,andgraduallyincreasingtheintensityandcomplexityoftheexercisesbasedonpatients’progress.

XunxiErhaoFangFunctionalExercise,describedbyZhangetal.(2019),isatypeoffunctionalexercisedesignedspecificallyforpatientswithdistalradiusfractures.Thisexerciseprogramincludesaseriesofwristandhandexercisesthatgraduallyincreasetherangeofmotionandstrengthofthewristandhand.

TheXunxiErhaoFangFunctionalExerciseprogramhasbeenshowntobeeffectiveinimprovingwristfunction,handgripstrength,andrangeofmotioninpatientswithdistalradiusfractures(Zhangetal.,2019).Thisexerciseprogramiseasytofollowandcanbeperformedathome,makingitaconvenientoptionforpatients.

Inconclusion,earlyrehabilitationaftersurgeryfordistalradiusfracturesisimportantforimprovingpatientoutcomes.TheXunxiErhaoFangFunctionalExerciseprogramisausefultoolinachievingbetterwristandhandfunctionaftersurgery.Itisimportantforhealthcareproviderstoeducatepatientsontheimportanceofearlyrehabilitationandencouragethemtostartearlywithappropriateexercises。Additionally,patientcomplianceandparticipationintherehabilitationprogramarecriticalfactorsthatcansignificantlyaffecttheoutcome.Itisimportantforhealthcareproviderstocommunicatewithpatientseffectively,answertheirquestions,andaddressanyconcernstheymayhave.Moreover,healthcareprovidersshouldcontinuouslymonitorthepatient'sprogressandprovidefeedbacktomakenecessaryadjustmentsintherehabilitationprogram.

Furthermore,theXunxiErhaoFangFunctionalExerciseprogramcanbeusedincombinationwithotherrehabilitationtechniquessuchasphysicaltherapy,occupationaltherapy,andmanualtherapytoenhancetherecoveryprocess.Physicaltherapycanhelpimproveflexibility,strength,andrangeofmotion,whileoccupationaltherapycanassistpatientsinadaptingtoactivitiesofdailyliving.Manualtherapycanalsohelpreducepainandfacilitatetissuehealing.

Finally,itisessentialtonotethatthesuccessofanyrehabilitationprogramreliesonindividualpatientcharacteristics,suchasage,sex,bonedensity,andoverallhealth.Therefore,healthcareprovidersshouldpersonalizetherehabilitationprogramtomeetthespecificneedsofeachpatient.Forinstance,olderpatientsmayrequirealongerrehabilitationperiod,whilepatientswithosteoporosismayneedspecialexercisestoimprovebonedensity.

Insummary,theXunxiErhaoFangFunctionalExerciseprogramisaneffectiveandpracticalapproachtorehabilitationaftersurgeryfordistalradiusfractures.Patientswhoadheretotheprogramarelikelytoexperiencesignificantimprovementsinwristandhandfunction,whichcanenhancetheiroverallqualityoflife.Healthcareprovidersplayavitalroleineducatingandmotivatingpatientstoparticipateintherehabilitationprocessandpersonalizetheprogramtomeettheirindividualneeds。InadditiontothephysicalbenefitsoftheXunxiErhaoFangFunctionalExerciseprogram,therearealsopsychologicalbenefitsthatcancontributetotheoverallwell-beingofpatients.Engaginginregularexercisecanimprovemood,decreasestressandanxiety,andpromotefeelingsofaccomplishmentandself-esteem.

However,itisimportanttonotethatrehabilitationafterdistalradiusfracturesurgeryrequirespatience,persistence,andacommitmenttotheprogram.Patientsmayexperiencediscomfort,stiffness,ortemporarysetbacksduringtherecoveryprocess,butwiththesupportofhealthcareprovidersandastructuredrehabilitationplan,theycanachieveexcellentoutcomes.

Moreover,holisticcareisessentialintherecoveryprocess.Inadditiontotheprescribedexercises,patientsneedtopayattentiontotheirdietandengageinotherhealthylifestylechoices.Adequatehydration,balancedmeals,andproperrestallcontributetooptimalhealing.

Healthcareprovidersmustalsotakeintoaccounttheindividualcircumstancesandpersonalgoalsofeachpatient.Rehabilitationprogramscanandshouldbepersonalizedtomeetthepatient'suniqueneedsandexpectations.Therefore,patient-centeredcareisessentialtoobtainthebestpossibleoutcomes.

Inconclusion,theXunxiErhaoFangFunctionalExerciseprogramisavaluableresourceintherehabilitationofdistalradiusfracturesurgerypatients.Itoffersaneffectiveandpracticalapproachtorestoringwristandhandfunction,improvingqualityoflife,andenhancingmentalwell-being.Withthesupportofhealthcareproviders,patientscansuccessfullynavigatetherecoveryprocessandregaintheirindependenceandconfidence。OnepotentialareaofimprovementfortheXunxiErhaoFangFunctionalExerciseprogramistheinclusionofeducationalmaterialstoenhancepatientunderstandingandcompliance.Patientswhoarebetterinformedandengagedintheirrecoveryprocessmaybemorelikelytoadheretotheprogramandachievebetteroutcomes.Additionally,incorporatingtechnologysuchasmobileappsorwearablesmayofferadditionalsupportandmotivationforpatients.

Anotherconsiderationistheindividualizationoftheprogramtomeettheuniqueneedsandchallengesofeachpatient.WhiletheXunxiErhaoFangFunctionalExerci