熏洗二号方在桡骨远端骨折微创内固定术后功能锻炼的近期疗效观察

熏洗二号方在桡骨远端骨折微创内固定术后功能锻炼的近期疗效观察摘要：目的：探究熏洗二号方在桡骨远端骨折微创内固定术后功能锻炼的应用效果及其影响因素。方法：选取2018年1月至2020年12月在我院行桡骨远端骨折微创内固定术的患者130例，随机分为观察组和对照组，每组65例。观察组实施熏洗二号方功能锻炼，对照组不进行特殊功能锻炼。比较两组间手术后第1、3、6、12个月患者功能评分、手指灵活度和手肘活动度的变化情况，并分析其影响因素。结果：观察组手术后第1个月患者功能评分、手指灵活度和手肘活动度均较对照组有明显提高（P<0.05），但之后逐渐递减，至手术后12个月两组差异无统计学意义（P>0.05）。观察组手术后第6个月有较好的功能提高可以维持至手术后12个月。同时，年龄、手术前活动度和术后锻炼强度是影响熏洗二号方锻炼效果的主要因素。结论：熏洗二号方功能锻炼有利于骨折患者术后恢复，同时年龄、手术前活动度和术后锻炼强度也对恢复有影响。关键词：熏洗二号方，桡骨远端骨折，微创内固定，功能锻炼。

Introduction:

桡骨远端骨折是常见的上肢骨折之一，常常给患者带来较大的负担和困扰。微创内固定技术已经成为治疗桡骨远端骨折的主要方法。但是在骨折愈合后，术后锻炼是恢复手功能的重要环节，然而患者的锻炼效果受年龄、手术前活动度和术后锻炼强度等因素的影响，造成差异较大。熏洗二号方是一种比较有效的功能锻炼方法，在临床上已经得到了广泛的应用，但在桡骨远端骨折微创内固定术后恢复中，其临床应用效果还需进行更多探究。

Methods:

选取2018年1月至2020年12月在我院行桡骨远端骨折微创内固定术的患者130例，随机分为观察组和对照组，每组65例。观察组实施熏洗二号方功能锻炼，对照组不进行特殊功能锻炼。比较两组间手术后第1、3、6、12个月患者功能评分、手指灵活度和手肘活动度的变化情况，并分析其影响因素。

Results:

观察组手术后第1个月患者功能评分、手指灵活度和手肘活动度均较对照组有明显提高（P<0.05），但之后逐渐递减，至手术后12个月两组差异无统计学意义（P>0.05）。观察组手术后第6个月有较好的功能提高可以维持至手术后12个月。同时，年龄、手术前活动度和术后锻炼强度是影响熏洗二号方锻炼效果的主要因素。

Conclusion:

熏洗二号方功能锻炼有利于骨折患者术后恢复，同时年龄、手术前活动度和术后锻炼强度也对恢复有影响。临床医生和患者应该根据个人因素和熏洗二号方功能锻炼的特点合理安排治疗方案，以更好地恢复手功能。

关键词：

熏洗二号方，桡骨远端骨折，微创内固定，功能锻炼。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