Effect Of Mechanical Dynamic Traction Combined With Functional Exercise On Functional Recovery After Ankle Fracture Surgery

The ankle joint is the main weight-bearing joint of the human body,and it is also one of the most vulnerable joints in daily life.The incidence of fractures accounts for about 3.92%of systemic fractures.The ankle joint needs good stability and flexibility to ensure its weight-bearing function and walking function.The height matching of the talus and ankle points is the basis of ankle joint weight-bearing.Clinically,for unstable ankle fractures,surgical methods are usually used to restore the matching relationship of the ankle joint to achieve accurate reduction of the anatomical structure.The purpose of the operation is to stabilize the fractured end and provide conditions for early functional rehabilitation exercises.Many ankle fractures with good recovery of anatomical relationship after operation still have dysfunction,and the reason may be closely related to the timing of postoperative rehabilitation and improper rehabilitation methods.More than 10%of postoperative patients with ankle fractures have ankle dysfunction due to various postoperative complications.The reason is due to local swelling and pain caused by the exudation of inflammatory substances in the fracture and inflammatory reactions.Moreover,surgery is also a traumatic intervention,which exacerbates the destruction of soft tissues and local inflammation.In the later stage,the adhesion of scars such as muscles and ligaments will cause joint stiffness and affect the joint function of patients.Traditional Chinese medicine believes that limb dysfunction is due to local meridian stasis and qi and blood stagnation,resulting in local qi and blood stasis,tendon and vein deprivation,and yin and yang imbalance.After ankle fracture,long-term braking will cause blood circulation disorders in muscles,tendons and other local soft tissues,causing the local muscles of the fracture to harden and increase tension,which increases the resistance to joint movement.Braking and disuse can cause ankle joints disfunction.With the development of modern rehabilitation medicine,various types and functions of ankle braces have been widely used in clinical practice.Common ankle orthosis includes plastic orthosis with ankle joint,metal band ankle orthosis,soft ankle orthosis,etc.,can be used for ankle sprain,ankle fracture postoperative rehabilitation exercise treatment,etc.They all have Excellent biomechanical performance and personalized design can effectively fix and protect the affected limb,and correct and prevent deformities of the ankle joint.However,the force of the traditional foot and ankle brace to stimulate the fracture end is not adjustable.If the force is too large,it may destroy the proliferation of osteoblasts,which is not conducive to fracture healing.If the force is too small,it cannot form the force of the soft tissues such as tendons,muscles and ligaments that stretch the contracture.The traditional manual training and rehabilitation scheme for ankle fractures relies on manual techniques,which is time-consuming and labor-intensive.The investment in rehabilitation training with instruments and equipment is relatively large and it is inconvenient to use because the instruments are cumbersome,and the medical resources for manual techniques are obviously insufficient.At present,most of the clinical rehabilitation models are for patients to visit the hospital regularly and perform rehabilitation exercises at a fixed time every week.Once the patient leaves the hospital,the patient’s autonomous family rehabilitation lacks professional guidance and the family generally does not have professional equipment for rehabilitation medicine.The patient leaves the hospital environment There are certain difficulties in achieving independent family rehabilitation.Based on this,in order to accurately regulate the force acting on the rehabilitation exercise of the affected limb,so that patients with ankle fractures can carry out weight bearing,walking,and functional exercise in a timely and safe manner,the application of a mechanical power traction method is an effective method.The rehabilitation treatment method is worthy of clinical research and explorationpurpose:To compare the therapeutic effect of mechanical dynamic traction combined with functional exercise and pure functional exercise on functional rehabilitation after ankle fracture,to verify the safety and effectiveness of mechanical dynamic traction in order to provide clinical treatment for dysfunction after ankle fracture Treatment programs.method:A total of 68 patients with ankle fractures admitted to Wangjing Hospital from October 2017 to October 2019 were selected,34 cases in each group,and the patients were divided into a treatment group and a control group by random number method.Lafa combined with functional exercise,the control group was simply given functional exercise treatment,and the patients were followed up after the operation,including pain VAS score,ankle swelling,ankle flexion and extension activity score,AOFAS score,and statistical analysis was performed to evaluate their efficacy.result:1:Both the treatment group and the control group were followed up for 6 months.General data such as gender,age,disease course,distribution of the affected side,surgical method,healthy side circumference and fracture classification of the two groups were statistically analyzed.The differences were not statistically significant(P>0.05),and were comparable.2:Before treatment,the preoperative VAS pain score of the two groups of patients passed the t test,P was greater than 0.05,and the difference was not statistically significant,indicating that the two groups were comparable.After treatment,the VAS pain scores of the two groups of patients passed the t test at 2 weeks and 1 month after ankle fracture,and the P was greater than 0.05,and the difference was not statistically significant.The VAS pain scores of the two groups of patients after 3 months and 6 months of postoperative ankle fracture were compared.After t test,P was less than 0.05,indicating that the difference between the two groups was statistically significant.3:Before treatment,the back extension angle and plantar flexion angle of the two groups were analyzed by t test,and the difference was not statistically significant(P>0.05),indicating that the two groups were comparable.After treatment,the ankle back extension angle and plantar flexion angle of the two groups of patients were analyzed by t test at 2 weeks,1 month,3 months and 6 months after operation,and P was less than 0.05,indicating that the treatment group can effectively improve the ankle joint back The difference between extension angle and plantar flexion angle is statistically significant.4:The postoperative swelling degree of the two groups of patients before treatment was analyzed by t test,and the difference was not statistically significant(P>0.05),indicating that the two groups were comparable.After treatment,the comparison of the swelling degree of the ankle fractures at 2 weeks,1 month,3 months and 6 months after operation was analyzed by t test,P>0.05,indicating no significant difference between the two groups.5:The scores of the two groups of patients in the evaluation criteria of January,March and June after surgery,including pain,function and autonomous activity,support,maximum walking distance(block),ground walking,hind feet Activity(inversion and valgus),foot alignment,t-test,P>0.05,the difference was not statistically significant.Among the abnormal gait,back-and-forth activity(flexion/extension),after t-test,the treatment group was significantly better It was statistically significant in the control group(P<0.05);the AOFAS scores of the two groups of patients were excellent at 6 months after surgery.The rank-and-test analysis showed that the treatment group had an excellent rate of 94.11%;the control group had an excellent rate of 61.76%,P<0.05,indicating that the two groups are comparable.Comparison of the total scores of symptoms and signs in the 6th month of treatment between the two groups was statistically significant P=0.000(P<0.05),which was statistically significant.There was a significant difference in the total scores of symptoms and signs in the 6th month between the two groups.in conclusion:Mechanical dynamic traction combined with early functional exercise can effectively relieve pain and swelling after ankle joint surgery,improve ankle dorsiflexion and plantar flexion dysfunction,and effectively promote functional rehabilitation in the late stage of ankle fracture,and the effect is better than simple early functional rehabilitation exercise,Worthy of clinical promotion.