Clinical Study On Rehabilitation Exercise Hoffa Fracture Under The Guidance Of Theory Of "Emphasis On Both Sinews And Bones"

Objective:To compare two different postoperative rehabilitation exercise programs based on active-passive exercise under the guidance of the theory of "equal emphasis on muscles and bones" and active exercise under the principle of painlessness,to observe the difference in clinical efficacy and to explore the effect of the theory of "equal emphasis on muscles and bones" on Hoffa The guiding significance and clinical application value of early rehabilitation exercise after fracture.Methods:From March 2018 to September 2020,42 patients with Hoffa fractures who were admitted to the Department of Orthopedics of Shandong Provincial Hospital of Traditional Chinese Medicine were divided into two groups by random number table:treatment group and control group,with 21 cases in each group.All patients were treated with simple braces to immobilize the affected limbs,and blood-activating and swelling drugs were used before the operation.To evaluate the preoperative variables and eliminate the interfering factors,the two groups of patients were treated with open reduction and internal fixation,and the soft tissues were fully protected during the operation.The postoperative treatment group was guided by the theory of "equal stress on both muscles and bones" under the guidance of scientific and reasonable early active-passive rehabilitation exercises;The control group underwent routine active rehabilitation exer cises under the principle of painlessness;the two groups of patients were treated with traditional Chinese medicine Huoxue Zhitong fumigant lotion(self-prepared by Shandong Provincial Hospital of Traditional Chinese Medicine)two weeks after the operation,the wounds healed and the skin sutures were removed for five days.The perioperative variables of the two groups of patients were recorded and compared,using the Hospital for special surgery knee score(HSS score),range of motion(ROM),and visual analogue pain score(visual analogue score).Scale,hereinafter referred to as VAS score)evaluate and analyze the knee function recovery of the two groups before operation,1 month,3 months,and 6 months after operation.By comparing the clinical effects of the two rehabilitation exercise methods,the guiding significance of the theory of "equal stress on bones and muscles" in rehabilitation exercise after Hoffa fracture was analyzed.Results:1.There was no significant difference in perioperative variables between the two groups of patients(P>0.05);2.In terms of HSS scores,the HSS scores of the two groups of patients gradually increased at the 1,3,and 6 months after surgery,and the HSS The scores have a significant interaction effect in different treatment cycles(P<0.05),indicating that the HSS scores in the two groups gradually increase with the extension of the treatment cycle.The HSS scores of the patients in the treatment group are higher than those of the control group,and the difference is statistically significant(P<0.05);3.In terms of knee ROM,the ROM of the two groups of patients increased gradually in the first 1,3,and 6 months after surgery,and ROM had a significant interaction effect in different treatment cycles(P<0.05),and the treatment group The range of motion of knee joints was significantly higher than that of the control group,and the difference was statistically significant(P<0.05);4.Comparative analysis of the treatment group and the control group in the first and third follow-up follow-up,6 months of VAS pain score,it was found that the VAS scores were gradually reduced(P<.0.05),the VAS scores of patients in the treatment group were lower than those in the control group at each period,and the difference was statistically significant(P<0.05);5.At the last follow-up,HSS score,the excellent and good rate of the treatment group was 85.71%,which was significantly higher than 61.91%of the control group,the difference was statistically significant(P<0.05).Conclusion:The theory of "equal stress on bones and muscles" guided early rehabilitation exercise after Hoffa fracture is an effective and reliable rehabilitation method.Combined with traditional Chinese medicine fumigation and washing treatment,the clinical effect is definite,and the postoperative limb function recovery is good.It is clinically worthy of promotion.