| BackgroundThe functions of the joint after fracture treatment are the most important in view of joint fracture.Research on postoperative complications relatively lags behind study on operative treatment of fracture.Clinical orthopedist only focuses on success of operation,but has inadequate understanding on functional rehabilitation after the operation.Particularly,there are rare studies concerning postoperative pains of patients with patellar fracture.How to improve pain symptoms and joint activity of patients is an important topic.It can further increase knowledge of clinicians on diseases by studying relevant postoperative complications,which is positive to postoperative rehabilitationofpatients.ObjectiveTherapeutic effect of patellar inward pushing method in patellar pains of 35 patients with patellar fracture and patellar medial retinaculum injuries was reviewed and analyzed.Besides,therapeutic effects of all patients before the treatment and at different time periods after the treatment were compared.Clinical effect of patella inward massage in patellar pains of patellar fracture with patellar medial retinaculum injuries was observed.MethodsA total of 35 injured knees of 35 patients with patellar pains after patellar fracture operation in our hospital from January 2016 to March 2017 were chosen,including 28 injured knees of 21 males and 14 injured knees of females.Respondents aged from 20-50,36.1±7.3 in average.All patellar fracture belonged to closed fracture.In view of fracture causes,there were 15 cases of fall injuries and 20 cases of car accidents.All patients suffered pure patellar fracture.Patients with complications of other serious injuries or fracture at other positions were eliminated.All respondents had no disease history of knee joint and patellar medial retinaculum injury was discovered in operation.Simple repair of patellar medial retinaculum was performed.All patients had different degrees of patellar pains after the operation.Operative treatment of AO tension band fixation was offered to all patients.All the patients according to the random number table method were randomly divided into two groups,the experimental group was given the treatment of patella interpolation.patellar inward pushing method within the affordable range of pains was performed,which was maintained for about 5s and the pressing actions were loosened slowly.Repeat these actions,30 times / group and 2 groups / d.The same non steroidal anti-inflammatory drugs in the experimental group were treated with the same non steroidal anti-inflammatory drugs as the control group.At 1 month and 3 months after the symptomatic treatment,range of motion(ROM)of knee joints,pain degree,impact on working,atrophy degree of patellar near-end,necessity of walking assistance,existence of effusion,existence of soft legs and stair climbing ability were assessed with reference of Bostman standards.Pains,functions,range of motion,muscle,buckling deformity and stability of patients were assessed with reference to the knee joint scoring standards of Hospital for Special Surgery(HSS).At the same time,20 rabbits were selected and randomly divided into A and B groups.Each group was divided into ten animals.Group B was on the left side and on the right side.Group A and group B were raised in the same indoor group.The food and water were given according to the same standard.Group A cut the medial patella support band of the right hindlimb,no suture support band,simply suture skin,and no special treatment on the left.In one group,the medial patella support band of left hindlimb was cut off,no suture was done,no special treatment was given on the right side,and two rabbits were killed after 2 months.To compare the pathological changes of patella cartilage in both sides of knee,the effect of medial patella support band on patella cartilage was clear.ResultsAll patients were evaluated before treatment,1 months after treatment and 3 months after treatment.All patients had no adverse events such as internal fixation failure.The average Bostman scores of all the patients in the experimental group were 24±2.17,26± 2.45 and 28±1.87 after treatment,1 months after treatment and 3 months after treatment.The average HSS scores of all patients before treatment,1 months after treatment and 3 months after treatment were 65±5.23,69±6.21 and 73±4.17 respectively.The average Bostman score of all the patients in the control group+ was 24±1.56 before treatment,24±2.34 after 1 months treatment and 24±3.10 after 3 months of treatment.All patients in the control group the average HSS score was 65±6.24 before treatment,after treatment for 1 months,65±5.44,3 months after treatment was 65±4.41,the experimental group all the patients showed statistically significant difference in the average score before and after treatment,there was significant statistical differences between the average score and treatment after 3 months of treatment after 1 months.All patients were relieved in varying degrees after treatment.All patients in the control group had no obvious relief after treatment,but no significant difference was found after statistical analysis.There were obvious changes in the patellar cartilage on the side of rabbit in group A and group B,which showed that the soft cells in the inner side of patella were different in size,arrangement and boundary was blurred.The surface of part cartilage appears superficial ulcer.There were no significant abnormal changes in the contralateral patellar cartilage in group A and group B.ConclusionsThis study proved significant therapeutic effects of patellar inward pushing method in patellar pains of patients with patellar fracture and patellar medial retinaculum injuries.Moreover,it can improve other evaluation indexes related with joint ROM.It has determined therapeutic effect and is worthy of clinical applications.It is concluded from animal experiments that the injury of the medial support band of patella has great influence on the articular cartilage of patella.It can cause clinical symptoms such as pain. |
PDF Full Text Request