The Clinical Research Of Surgical Intervention And Rehabilitative Management In 34 Patients With Sequela Of Crush Injury In The Eearthquake

Objective:To investigate the clinical effect of surgical intervention and rehabilitative management in patients with sequela of crush injury in the eearthquakeMethods:34 patients with limb dysfunction of crush injury in the earthquake were give marks to assess the global function with SF-36 health survey,assessment of activities of daily living (The Barthel Index) preoperatiively and postoperatively, and limb fuction with the trial standard of evaluation of peripheral nerve function by Hand Surgeryof Chinese Medical Association,evaluation criteria of sciatic nerve injury by Clawson and Seddon,assessment standards of wrist by Cooney,Ankle-Hindfoot Scale by AOFAS, the clinical evaluation criteriaof Achilles tendon injury by Termann, rehabilitation assessment method of peripheral nerve injury to assess the corresponding of limb function.The appropriate surgical treatment and postoperative rehabilitation program were used based on the specific conditions of patients(neurolysis, coinciding or grafting, muscle and scar releasing, tendon lengthening or transposition).All patients were evaluating again at the following-up 6 and 12 months postoperatively and observed the limb sensation, muscle strength, range of motion, recovery of life.Results:The ttest of two independent-samples btween preoperatively and postoperatively of every item of SF-36scale of 34 patients resulted in p<0.01,the difference was statistically significant. The scoresof BarthelIndexof34patientswere76.03±10.99 preoperatively,86.32±8.01at the time of the first following-up,93.53±5.97 at the timg of the second following-up,and the t test of paired-samples resulted in p<0.01,the difference was statistically significant. The scores of Ankle-Hindfoot Scale by AOFAS of 14 patients were 64.64±15.08 preoperatively,81.43±8.68at the time of the first following-up,92.07±6.12 at the timg of the second following-up,and the test of paired-samples resulted in p<0.01,the difference was statistically significant. The scores of 14 patients with ulnar nerve injury were 5.86±1.46 preoperatively,87.57±1.90at the time of the first following-up,9.86±1.07 at the timg of the second following-up,and the t test of paired-samples resulted in p<0.01,the difference was statistically significant. The scores of 8 patients with median nerve injury were6.38±1.77, preoperatively,9.88±0.99 at the time of the first following-up,13.75±1.58 at the timg of the second following-up,and the t test of paired-samples resulted in p<0.01,the difference was statistically significant. The scores of 4 patients with radial nerve injury were 6.25±3.30, preoperatively,9.00±1.83 at the time of the first following-up,13.50±1.9 at the timg of the second following-up,and the t test of paired-samples resulted in p<0.01,the difference was statistically significant. The scores of 4 patients with tendon injury were 38.00±7.16, preoperatively,69.75±4.57 at the time of the first following-up,79.25±3.30 at the timg of the second following-up,and the t test of paired-samples resulted in p<0.01,the difference was statistically significant.Conclusion:Muscle strength, sensation, range of motion, ease of life has improved significantly in all patients who were treated with thesurgical intervention and rehabilitative management.