Effect of Progressive Functional Exercise on Double Steel Plate Internal Fixation of Distal Humerus C Type Fracture
TIAN Yu-liang,YU Hai-quan,Cao Bin
The Third Department of Orthopaedics, Shijiazhuang First Hospital, Shijiazhuang 050011, China
Abstract:
Objectives To investigate the effect of progressive functional exercise on elbow joint function after double steel plate internal fixation for distal humerus C type fractures. Methods Eighty patients with distal humerus C type fractures that accorded with the inclusion criteria treated with double steel plate internal fixation were selected and randomly divided into treatment group and control group after operation (n=40). After operation, the patients in treatment group were given progressive functional exercise. In the control group, the affected limb was fixed and braked at the position of 30° elbow extension, and functional exercise was started one week later (7–11 days after operation). Elbow joint function was compared between the two groups 2 weeks,3 months and 6 months postoperatively by elbow joint Mayo scale; the elbow range of motion and complications 6 months after surgery were compared. Results All the 80 patients were followed up, the treatment group and control group in elbow joint pain, activity, stability and ADL ability were significantly different between 3 months and 6 months after surgery and 2 weeks after surgery (P <0.05); the pain scores of the elbow joints in the treatment group were higher than those in the control group at 3 months and 6 months after operation (P <0.05);The treatment group and control group in elbow flexion, elbow extension, forearm pronation and forearm curl were significantly different between 3 months and 6 months after surgery and 2 weeks after surgery (P <0.05). The elbow flexion, elbow straight difference degrees,Forearm pronation degrees and Forearm curl degrees of the treatment group 3 months and 6 months after operation were higher than those of the control group(P<0.05); 3 months after surgery, Wilcoxon rank sum test was performed on the rates of excellent and good in the two groups (Z= –1.976, P<0.05). 6 months after surgery, Wilcoxon rank-sum test was performed on the excellent and good rates of the two groups (Z= –2.042, P<0.05); No incision infection or vascular and nerve injury occurred in the two groups 6 months after surgery, and the comparison of total postoperative complications was not statistically significant (P>0.05). Conclusions Early progressive functional exercise after double steel plate internal ?xation of distal humerus C type fractures has obvious advantages in elbow range of motion, functional recovery and pain relief, which is safe and reliable.
