| Objective:this study expected by prospective randomized controlled study confirmed that the humerus distal type C fractures of immediate postoperative function exercise and postoperative 1 weeks elbow function exercise of elbow joint function rehabilitation if there is a difference, and further confirmed for 1 weeks post-operation different position differences about the existence of elbow joint function recovery. For the humerus distal type C fractures of postoperative rehabilitation to provide a more comprehensive and effective method. Methods:this study intends to choose during June 2013 to July 2013 in Sichuan Provincial People’s Hospital and the first people’s Hospital of Shuangliu County, a total of 90 cases of orthopedic humerus distal type C fracture surgery patients, and randomly divided into 3 groups. Group A:postoperative begin elbow joint function exercise.30 cases, including 16 cases of male, female 14 cases, mean age 38.4±13.26 years. AO type:C1 type 8 cases,16 cases C2 type, C3 type 6 cases. Operation time:1-3 days after injury surgery:2 cases,4 to 7 days after injury surgery:26 cases,8 to 14 days after injury surgery:2 cases; Group B:postoperative plaster external fixation in the 90°elbow flexion was 1 weeks elbow joint function exercise. 30 cases,19 cases of male, female in 11 cases, mean age 39.43±13.27 years. AO type:C1 type 9 cases,15 cases C2 type, C3 type 6 cases. Operation time: 1-3 days after injury surgery:1 case,4 to 7 days after injury surgery:27 cases,8 to 14 days after injury surgery:2 cases; Group C:plaster external fixation postoperatively in stretch 30°elbow a brake to elbow function exercise after 1 week.30 cases, of which the male 17 cases,13 cases of female, average age 40.97+40.97.10 cases of AO type:type C1, C2 type 15 cases, C3 type in 5 cases. Operation time:1-3 days after injury surgery:2 cases,4 to 7 days after injury surgery:27 cases, injury:8 to 14 days after surgery in 1 case. Observe the patient’s pain, elbow motion functions such as situation, choose the Mayo elbow function scoring system to assess elbow overall functional recovery in patients with three groups, choose pain visual analog scale (VAS) to assess the patient’s pain degree, patients are measured with a protractor elbow flexion and forearm selection range. Results:90 patients received postoperative follow-up, June-21 months follow-up time. A group of 30 cases of patients with postoperative average eight to 12 weeks of clinical healing, all were primary healing of incision, among them 2 cases occurred elbow myositis ossificans,2 cases of traumatic sex arthritis,1 case of wound inflammation, wound inflammation after symptomatic treatment. B group of 30 cases of patients with postoperative clinical healing, an average of 7-12 weeks of all were primary healing of incision, including 3 cases of myositis ossificans elbow,1 case of wound inflammation, wound inflammation after symptomatic treatment. C group of 30 cases of patients with an average of 9-12 weeks of clinical healing postoperatively, all were primary healing of incision, including 3 cases of myositis ossificans elbow performance. Conclusions:the distal humerus type C fracture elbow after short-term brake again with functional exercise, although 2 weeks postoperative pain more immediate function of exercisers, apparently in elbow Mayo in June but the postoperative pain score, visual score (VAS), to a certain extent, elbow flexion and activities, etc is superior to the immediate function of exercisers. Distal humerus type C fracture elbow function of braking and immediate short-term exercisers in influencing elbow, have no obvious difference on the rotation function. Distal humerus C type fractures elbow flexion after braking and elbow flexion 30 degrees 90 degrees of short-term short-term brake, after June, pain in the elbow Mayo score, visual score (VAS), elbow, elbow flexion mobility no significant different in the rotating motion. Distal humerus type C fractures of postoperative CPM machine early intervention, a gradual increase of active and passive functional exercise can promote limb venous return, reduce swelling, prevent venous thrombosis, improve muscle strength and joint mobility, reduce the surrounding tissue adhesion, improve joint function. Distal humerus type C fractures in combination with two parallel plates and screws, gram can effectively block fracture fixation needle, increases the stability of fracture, is conducive to the early functional exercise.Distal humerus type C fractures of postoperative functional exercise under the guidance of clinical doctors, step by step, after the brake is beneficial to alleviate edema, reduce the wound bleeding, local swelling, pain, etc, is beneficial to patients with elbow function recovery. |
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