三維力學在治療手外傷后關節僵硬的臨床研究

薛春花

【摘要】 目的 探索三維力學在治療手外傷后關節僵硬的臨床效果。方法 60例首次發生手外傷術后恢復期患者， 隨機分為A組、B組和C組， 每組20例。A組予以傳統運動療法聯合一般動態支具治療， B組予以傳統運動療法聯合三維力學支具治療， C組予以三維力學治療方法聯合三維力學支具治療。對三組的臨床療效以及手功能評估情況進行對比分析。結果 C組治療總有效率為90.00%， 高于

A組的60.00%和B組的60.00%， 差異具有統計學意義（P<0.05）。A組與B組治療總有效率比較， 差異無統計學意義（P>0.05）。A組手指主、被動屈曲度增加值高于B組、A組， B組手指主、被動屈曲度增加值高于A組， 差異具有統計學意義（P<0.05）。結論 三維力學治療手外傷后關節僵硬療效顯著， 有助于改善骨折愈合不良患者后期功能恢復， 適宜臨床應用推廣。

【關鍵詞】 三維力學；手外傷后關節僵硬；關節僵硬改善程度

DOI：10.14163/j.cnki.11-5547/r.2018.02.007

Clinical study of three-dimensional mechanics in the treatment of joint stiffness after hand trauma XUE Chun-hua. Dongguan Humen Hospital， Dongguan 523929， China

【Abstract】 Objective To investigate the clinical effect of three dimensional mechanics in the treatment of joint stiffness after hand trauma. Methods A total of 60 postoperative recovery patients of first hand injury were randomly divided into group A， group B and group C， with 20 cases in each group. Group A received traditional sports therapy combined with general dynamic support， group B received traditional sports therapy combined with three-dimensional mechanical support， and group C received three-dimensional mechanical therapy combined with three-dimensional mechanical support. Comparison and analysis were made on clinical efficacy and hand function assessment between two groups. Results Group C had higher total treatment effective rate as 90.00% than 60.00% in group A， and the difference was statistically significant （P<0.05）. Group A and group B had no statistically significant difference in total treatment effective rate （P>0.05）. Group C had higher added value of finger active and passive flexion than group B and group A， and group B had higher added value of finger active and passive flexion than group C. Their difference was statistically significant （P<0.05）.

Conclusion Three-dimensional mechanics provides remarkable efficacy in treating joint stiffness after hand trauma， and helps improve functional recovery of patients with bad fracture healing. It is suitable for clinical application and promotion.

【Key words】 Three-dimensional mechanics； Joint stiffness after hand trauma； Joint stiffness improvement在日常生活和從事生產勞動中， 由于手部較其他部位暴露機會較多， 手部創傷最為常見。治療手外傷后關節僵硬的主要手段為運動療法以及支具牽拉， 上述兩種治療手段在骨折愈合不良患者中效果一般， 且支具牽拉由于無法避開兩關節面擠壓力能夠誘發關節炎[1]。因此， 臨床尋求一種優良的治療關節僵硬措施尤為關鍵。本文就三維力學在治療手外傷后關節僵硬的理論及實踐應用策略進行觀察研究， 旨在為骨折愈合不良患者后期功能恢復欠佳的現狀提供新的治療策略， 現報告如下。

1 資料與方法

1. 1 一般資料 選取2015年10月～2016年10月在本院骨科收治的60例首次發生手外傷術后恢復期患者， 按照隨機數字分配法隨機分為A組、B組和C組， 各20例。A組男13例， 女7例；體力勞動15例， 腦力勞動5例；……