前足静态畸形手术治疗后患者的康复

D. Prozorovskiy, V. Staude, R. Buznytskiy
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The patients were divided into 2 homogeneous groups by age, gender and degree of hallux valgus. Unlike the control group, manual therapy and myofascial massagetechniques were additionally used in the main group. The results. The results of the treatment were evaluated according to the AOFAS scoring scale for the forefoot, which is generally accepted inthe world. In the preoperative period, the average AOFAS score in the main and control groups was 65.4 and 64.7 points, respectively. 45 days after surgery, the average scores were 74.7 and 74.4 points,respectively. After 60 days, the average score in the main group was 92.1 points, and 82.6 in the control group. 3 months (90 days) after the surgical interventions, the average scores practically coincided in both groups and amounted to 93.7 points in the control group and 95.0 in the main group. 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引用次数: 0

摘要

拇外翻患者的术后康复与技术上完美的手术干预同样重要,甚至更重要。实施康复措施是术后阶段的一个组成部分,术后阶段必须针对每个患者,并取决于手术干预的数量和类型、患者的年龄和伴随的病理学。客观的由于复杂的术后康复系统的发展,提高患者在足部前部骨科手术干预后的康复效果。方法。本文分析了70例前足横向伸展变形和拇外翻1-2度患者术后采用不同康复措施的治疗结果。患者按年龄、性别和拇外翻程度分为2组。与对照组不同,主要组额外使用了手法治疗和肌筋膜按摩技术。结果。根据国际公认的前掌AOFAS评分表对治疗结果进行评估。术前,主要组和对照组的平均AOFAS评分分别为65.4分和64.7分。术后45天,平均得分分别为74.7分和74.4分。60天后,主组的平均得分为92.1分,对照组为82.6分。手术干预后3个月(90天),两组的平均得分几乎一致,对照组为93.7分,主组为95.0分。主要组患者在2个月后恢复了正常活动。术后足前部,对照3个月。结论。采用肌筋膜按摩、手法治疗结合体操活动趾跖趾和趾间关节,不仅增强了足部的稳定器,还恢复了下肢束带的承受能力和行走的刻板印象,不仅取得了积极的功能效果,而且与对照组相比每月也能加快恢复速度。
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REHABILITATION OF PATIENTS AFTER SURGICAL TREATMENT OF STATIC DEFORMITIES OF THE FOREFOOT
Postoperative rehabilitation of patients with hallux valgus is just as important, if not more so, than a technically flawless surgical intervention. Carrying out rehabilitation measures is an integral part of the postoperative period, which must be individual for each patient and depend on the volume and type of surgical intervention, the patient's age, and accompanying pathology. Objective. To improvethe results of the recovery of patients after orthopedic surgical interventions on the front part of the foot due to the developed complex system of postoperative rehabilitation. Methods. The articleprovides an analysis of the results of treatment of 70 patients with transversely spread deformation of the forefoot and hallux valgus 1–2 degrees using different approaches to rehabilitation measuresin the postoperative period. The patients were divided into 2 homogeneous groups by age, gender and degree of hallux valgus. Unlike the control group, manual therapy and myofascial massagetechniques were additionally used in the main group. The results. The results of the treatment were evaluated according to the AOFAS scoring scale for the forefoot, which is generally accepted inthe world. In the preoperative period, the average AOFAS score in the main and control groups was 65.4 and 64.7 points, respectively. 45 days after surgery, the average scores were 74.7 and 74.4 points,respectively. After 60 days, the average score in the main group was 92.1 points, and 82.6 in the control group. 3 months (90 days) after the surgical interventions, the average scores practically coincided in both groups and amounted to 93.7 points in the control group and 95.0 in the main group. The patients of the main group resumed their usual activities after 2 months. after the operation onthe front part of the foot, and the control after 3 months. Conclusions. The use of myofascial massage, manual therapy for mobilizing the metatarsophalangeal and interphalangeal joints of the toes with gymnastics to strengthen not only the stabilizers of the foot, but also to restore the bearing capacity of the girdle of the lower extremities and the stereotype of walking, made it possible to obtainnot only a positive functional result, but also to speed up the recovery compared to the control group per month.
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