Department of Rehabilitation, Dongyang People's Hospital, Dongyang, Zhejiang, China.
Department of Orthopedics, Dongyang People's Hospital, Dongyang, Zhejiang, China.
J Back Musculoskelet Rehabil. 2021;34(6):957-964. doi: 10.3233/BMR-200279.
The aim of the study was to identify the efficacy of dynamic fixation using rigid tape (RT) in rehabilitation after surgery of terrible triad injury of the elbow (TTIE).
Sixty patients who underwent surgery of TTIE were equally randomly divided into RT group and hinged external fixation brace (HEFB) group. Dynamic fixations were applied for 8 weeks. General rehabilitation programs were performed for 3 months, 5 times a week. Follow-up (FU) was at six months. Main outcomes included pain (Visual Analogue Scale, VAS), muscle strength, range of motion (ROM), Elbow Function (Mayo Elbow Performance Index, MEPI), Quality of Life (QOL) (Short Form 36 Questionnaire, SF-36).
There were significant time x group interactions for pain, ROM, MEPI, SF-36 (all p= 0.000), which demonstrated positive efficacy of both the two interventions. Difference at each time-point (except for baseline) of pain and ROM between the two groups was statistically significant (all p< 0.05). Some differences between the two groups were not statistically significant which at 14d on MEPI (p= 0.108) and at 21d (p= 0.259) and FU (p= 0.402) on QOL. Moreover, the increased muscle strength at each time-point had no statistically significant difference between the two groups (all p> 0.05).
Both RT and HEFB could significantly improve the postoperative functional outcomes of the TTIE. However, early rehabilitation intervention could increase pain, which affected the corresponding function (MEPI) and QOL. Note that this kind of impact was short-term and reversible. The muscle strength and ROM were not affected by the increased severe pain, maintaining a trend of improvement. In addition, the subjects in the RT group improved faster and more efficiently and had better results with pain, ROM, MEPI, and QOL compared to the subjects in the HEFB group.
本研究旨在探讨使用刚性胶带（RT）进行动态固定在肘部三联征损伤（TTIE）术后康复中的疗效。
将 60 例接受 TTIE 手术的患者随机均分为 RT 组和铰链式外固定支具（HEFB）组。两组均采用动态固定 8 周。在术后 3 个月内，每周进行 5 次一般性康复治疗。在 6 个月时进行随访。主要结局指标包括疼痛（视觉模拟评分，VAS）、肌肉力量、关节活动度（ROM）、肘部功能（Mayo 肘部功能指数，MEPI）和生活质量（36 项简短健康调查问卷，SF-36）。
疼痛、ROM、MEPI 和 SF-36 均存在时间×组间交互作用（均 p=0.000），表明两种干预措施均具有积极疗效。两组在每个时间点（除基线外）的疼痛和 ROM 差异均具有统计学意义（均 p<0.05）。两组间在某些时间点的差异无统计学意义，即 14d 时的 MEPI（p=0.108）和 21d 时的 MEPI（p=0.259）和 6 个月时的 QOL（p=0.402）。此外，两组间在每个时间点的肌肉力量增加均无统计学差异（均 p>0.05）。
RT 和 HEFB 均可显著改善 TTIE 的术后功能结局。然而，早期康复干预会增加疼痛，从而影响相应的功能（MEPI）和生活质量。需要注意的是，这种影响是短期的和可逆的。肌肉力量和 ROM 不受疼痛加剧的影响，保持改善的趋势。此外，与 HEFB 组相比，RT 组的患者在疼痛、ROM、MEPI 和 QOL 方面恢复更快、更有效，结果更好。
