A Study On The Efficacy Of Postoperative Rehabilitation Exercises For Middle-aged And Elderly People With Proximal Humerus Fractures Using The Theory Of "Combining Tendon And Bone"

Objective: The efficacy of the rehabilitation exercise program guided by the theory of "tendon and bone" in Chinese medicine and the conventional rehabilitation exercise program was evaluated in terms of pain,swelling,fracture healing time,shoulder joint function recovery and postoperative complications after internal fixation with an incisional locking plate for proximal humerus fractures in middle-aged and elderly patients.According to this study,the results and clinical significance of this theory on the postoperative efficacy of proximal humerus fracture in middle-aged and elderly patients were investigated,in order to enrich the postoperative rehabilitation program of proximal humerus fracture for middle-aged and elderly patients,to guide the clinical treatment more specifically,and to further improve the overall efficacy.Methods: According to the inclusion and exclusion criteria established before the study,52 middle-aged and elderly patients with proximal humerus fractures who visited the orthopedic ward of the our Hospital between December 2020 and June 2022 were collected and randomly divided into group A(treatment group)and group B(control group)using a simple randomized control method,numbered according to the order in which the patients were seen,using a random number table.The patients were randomly divided into group A(treatment group)and group B(control group)using a random number table,with 26 cases in each group.After adequate preoperative preparation and exclusion of contraindications to surgery,both groups underwent internal fixation of proximal humerus fracture with an incision and locking plate under the same surgical plan.Postoperatively,both groups were treated as usual,and the control group was given a routine postoperative rehabilitation program according to the guidelines,while the treatment group was given a rehabilitation program under the guidance of "tendon and bone" theory and according to the characteristics of the middle-aged and elderly groups.The postoperative complications were evaluated by using VAS score to assess the improvement of pain,comparing the elimination of swelling of the affected shoulder before and after treatment,performing DR or CT imaging to assess the time of bony healing,and using the Neer score of the shoulder joint to assess the overall recovery of shoulder function.Results: The VAS scores on the 1st postoperative day were statistically analyzed,and there was no difference(P> 0.05).The pain scores on the 3rd postoperative day and the pain scores on the 7th postoperative day were compared between groups,and P was less than 0.05,which was different,and the pain relief effect of the treatment group was better than that of the control group patients.The Neer score of the shoulder joint was higher in the treatment group than in the control group at the 1st and 3rd months after surgery(P<0.05),but there was no difference by the 6th month after surgery(P>0.05).There was no difference in the improvement of swelling and fracture healing time in the affected shoulder between the two groups(P>0.05).No complications such as nonunion or delayed fracture healing,plate loosening or screw breakage occurred in either group.Conclusion: In the middle-aged and elderly patients with proximal humerus fracture,the rehabilitation exercise under the guidance of "tendon and bone together" theory is more effective in improving the pain in the early postoperative period and more efficient in the functional rehabilitation of shoulder joint without aggravating the risk of postoperative complications,and the clinical efficacy is worth affirming.