Evaluation of osteopathic treatment of patients with distal tibia fractures in the late postoperative period

Background. The postoperative period is often accompanied by pain and limited mobility in the ankle joint. There is a need to evaluate the effectiveness of additional rehabilitation methods in the late postoperative period. Aim. Evaluation of the effectiveness of complex (standard + osteopathic) treatment compared with standard restorative treatment in patients with distal tibia fractures in the late postoperative period. Material and methods. In the course of a randomized study, patients in the late postoperative period (68 weeks after surgery; n=40) were divided into two groups: the main group (n=20) received a standard rehabilitation treatment regimen and osteopathic treatment (correction of identified somatic dysfunctions); the comparison group (n=20) only the standard rehabilitation treatment regimen. The amplitude of motion of the affected ankle joint was assessed using a goniometer, the level of pain in the affected ankle joint was assessed using a visual analogue scale, and the level of quality of life was assessed using the SF-36 questionnaire. Data are presented as arithmetic mean and standard deviation M (SD). When analyzing intergroup differences, the nonparametric MannWhitney test (U-test) was used; when analyzing intragroup differences, the nonparametric Wilcoxon test (W-test) was used. The critical level of statistical significance was taken as 5% (p=0.05). Results. The addition of osteopathic treatment to the standard scheme led to a significant decrease in the level of pain (0.3 points in the main group, 1.5 points in the comparison group; p=0.0026), an increase in the amplitude of active movements in the ankle joint (64.7 in the main group, 51.8 in the comparison group; p=0.000217), improvement in the quality of life physical functioning (an increase in the indicator in the main group by 39 points, in the comparison group by 26 points), general health (an increase in the indicator in the main group by 47 points, in the comparison group by 28 points). Conclusion. Combined treatment (standard plus osteopathic) improves the results of restorative treatment compared with standard therapy alone in patients with fractures of the distal tibia in the late postoperative period.