郑氏推拿手法在Chopart关节骨折脱位术后至脱拐行走期的临床运用研究

目的]探讨郑氏推拿对Chopart关节骨折脱位术后至脱拐行走期中康复的疗效。方法]自2017年8月—2019年3月四川省骨科医院收治的67例Chopart关节骨折脱位并行切开复位内固定手术的患者,术后将患者随机分为研究组和对照组,对照组予术后常规功能锻炼,研究组在对照组的基础上予郑氏推拿手法治疗,直至患者除去内固定物脱拐行走4周,对比分析两组患者术后去除内固定物脱拐行走后1、3、6个月的视觉模拟评分法(VAS)评分及美国足踝外科协会(AOFAS)评分。结果]术后去除内固定物脱拐行走后1、3、6个月AOFAS评分,研究组(60.32±7.64、86.58±8.54、92.56±9.13)分均高于对照组(54.32±7.32、81.53±7.03、85.14±7.23)分,同时间点组间比较差异具有统计学意义(P<0.05)。术后去除内固定物脱拐行走后1、3、6个月VAS评分,研究组(3.06±0.25、2.29±0.50、0.42±0.16)分均低于对照组(3.78±0.47、2.84±0.24、1.25±0.43)分,同时间点组间比较差异具有统计学意义(P<0.05)。术后优良率研究组明显高于对照组,组间比较差异具有统计学意义(P<0.05)。结论]郑氏推拿手法对Chopart关节骨折术后至脱拐行走期的康复有着明显疗效,可明显改善患者术后疼痛及功能活动,应伴随术后康复全过程,值得临床推广。

Clinical application research of ZHENG's massage in the period from Chopart joint fracture and dislocation postoperative to walking without crutches

Objective] To explore the curative effect of ZHENG''s massage on the rehabilitation from Chopart joint fracture and dislocation postoperative to walking without crutches.Methods] From August 2017 to March 2019,the 67 patients with Chopart joint fracture and dislocation were treated with open reduction and internal fixation. The patients were randomly divided into study group and control group after operation. The control group was given routine functional exercise after operation,while the study group was given ZHENG''s massage manipulation on the basis of the control group until the patients walked for 4 weeks after removing the internal fixation. The VAS scores and AOFAS scores of two groups were compared at 1,3 and 6 months after the removal of internal fixation and walking.Results] The AOFAS scores of the patients of the study group (60.32±7.64,86.58±8.54,92.56±9.13) were higher than those in the control group (54.32±7.32,81.53±7.03,85.14±7.23) in 1 month,3 months and 6 months after the removal of internal fixation and walking,the comparison between two groups was statistically significant (P<0.05). The VAS scores of the patients in the study group (3.06±0.25,2.29±0.50,0.42±0.16) were lower than those in the control group (3.78±0.47,2.84±0.24,1.25±0.43) in 1 month,3 months and 6 months after the removal of internal fixation and walking,the comparison between groups was statistically significant (P<0.05). The excellent rate of the study group was significantly higher than that in the control group,and the comparison between two groups was statistically significant (P<0.05).Conclusion] ZHENG''s massage manipulation has obvious curative effect on the rehabilitation from Chopart joint fracture operation to walking period,and can obviously improve the postoperative pain and functional activities of patients,which should be accompanied by the whole process of postoperative rehabilitation,and is worthy of clinical promotion.