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Objective:To evaluate the efficacy of combining modified manipulative reduction with functional training for the treatment of acute anterior disc displacement without reduction.Methods:Sixty anterior disc displacement patients aged from 19 to 55 years were randomly divided into an experimental group and a control group, each of 30. The experimental group was given modified manipulative reduction, while the control group was provided with traditional manipulative reduction. After the manipulative reduction, both groups received 3 months of functional training. Visual analog scale (VAS) ratings, maximum active mouth opening, a mandibular movement index and magnetic resonance imaging (MRI) were employed before and immediately after the reduction and after the functional training to evaluate their effectiveness. An oral health-related quality of life scale was also used. The number of attempts needed to achieve successful reduction and the overall success rate were compared between the two groups.Results:There was significant improvement in the average VAS ratings, maximum active mouth opening, mandibular movement index and oral health-related life quality of both groups after the experiment. Immediately after reduction, the maximum active mouth opening and mandible movement in the experimental group were significantly higher than in the control group, on average. Further improvement was observed after the treatment such that there was no significant difference between the two groups. After the functional training, however, the experimental group′s average VAS and oral health-related life quality scores were significantly better than the control group′s averages. According to MRI right after reduction, the success rate of the experimental group (96.7%) was significantly better than among the control group (80%). After the functional training the corresponding values were 86.7% and 73.3%. That difference was no longer significant. There was also no significant difference in the number of attempts needed to achieve successful reduction.Conclusion:The modified manipulative reduction not only has a higher success rate, but also can immediately improve mouth opening and mandible mobility. Combined with functional training, it can effectively reduce pain and improve life quality.
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Objective nvestigate the propofol combined with fentanyl anesthesia in orthopedic manual reduction applications.MethodsAugust 2015 to December 2016 in our hospital treated 120 cases of acute long bone closed fracture and ankle, shoulder dislocation and other patients, efficient analysis anesthesia, surgery time, patient recovery time, propofol is added volume and total volume, and detection 3min, 1min, 3min, 5min and waking SpO2, HR, MAP, RR values.Two groups of patients after treatment, were given nursing intervention, such as routine diet guidance, nutrition support, health education.after administration before it is administered.Resultsanesthetic effect experimental group total efficiency is higher, the difference was statistically significant (P<0.05);after simultaneous administration of all patients 1min, 3min, 5min signs were lower than prodrug 3min signs, the difference statistically significant (P<0.05), after clear signs of its former administration 3min with no significant difference;experimental group recovery time, propofol bolus of propofol than with total control were lower, the difference was statistically significant (P<0.05);and the two groups were similar to the operation time, the difference was not statistically significant.ConclusionIn summary, propofol combined with fentanyl anesthesia for patients to take the treatment of orthopedic manual reduction obviously worthy of clinical use.
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Objective To explore the application of propofol combined with small dose fentanyl in manual reduction anesthesia in orthopedics.MethodsOctober 2014 to August 2016 in Huzhou central hospital treated 120 cases of acute long bone closed fracture and ankle, shoulder dislocation and other patients, efficient analysis anesthesia, surgery time, patient recovery time, propofol is added volume and total volume, and detection 3min, 1min, 3min, 5min and waking SpO2, HR, MAP, RR values.After administration before it is administered.ResultsAnesthetic effect experimental group total efficiency is higher, the difference was statistically significant (P<0.05);after simultaneous administration of all patients 1min, 3min, 5min signs were lower than prodrug 3min signs, the difference statistically significant (P<0.05), after clear signs of its former administration 3min with no significant difference;experimental group recovery time, propofol bolus of propofol than with total control were lower, the difference was statistically significant (P<0.05);and the two groups were similar to the operation time, the difference was not statistically significant.ConclusionIn summary, propofol combined with entanyl anesthesia for patients to take the treatment of orthopedic manual reduction obviously.
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Objective To investigate the effects of Duyiwei capsule combined with traditional bone setting manipulation treatment of senile femoral intertrochanteric fracture clinical effect, for clinical elderly femoral intertrochanteric fracture clinical treatment in patients with reference. Methods 86 elderly patients with intertrochanteric fracture in Yuyao Hospital of Traditional Chinese Medicine from April 2014 to May 2015 were randomly divided into control group and observation group, 43 cases in each group. The control group using tibial tubercle traction, after traction with the traction arch to maintain. The observation group was treated by TCM manipulation combined with Duyiwei capsule. Continuous treatment for two weeks in two groups. The quality of life and clinical efficacy were compared between the two groups after treatment score, pain score, fracture healing time, hospitalization time, Harris score, evaluation of traditional Chinese medicine treatment of manipulative reduction combined with Duyiwei capsule of senile intertrochanteric fracture clinical effect. Results Two groups of patients after 2 weeks of treatment, The quality of life score, the Harris score of the observation group was significantly higher than the control group, the difference was statistically significant (P<0.05), pain scores were significantly I control group, healing time and hospitalization time were significantly shorter than the control group, the difference was statistically significant (P<0.05). The observation group excellent rate 90.7%was significantly higher than the control group 65.12%, the difference was statistically significant (P<0.05). Conclusion Duyiwei capsule combined with TCM manipulation for treatment of intertrochanteric fracture of femur in the elderly curative effect, effectively improve the patient's clinical experience, is suitable for the elderly femoral intertrochanteric fracture patients with a clinical treatment plan.
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Distal radius fractures often occur in the elderly.At present,there has not yet reached a consensus on how to take effective measures for the treatment of such fractures in clinical.There are many different therapeutic methods for this fracture with different effect.Based on the summary of the relevant literature,the epidemiological characteristics of fractures of the distal radius,treatment,implant selection,surgical procedure,complications and prevention were summarized,in order to provide references for clinical treatment.
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Objective:To observe the clinical effects of extraoral manual reposition approach in the treatment of acute anterior disloca-tion of temporomandibular joint. Methods:98 patients with acute anterior dislocation of temporomandibular joint were divided into 2 groups(n=49) by random digit table and treated by manual reposition through intraoral and extraoral approach respectively. The suc-cess rate, success time, patient pain during treatment, SBP, DBP, HR and patient satisfaction were evaluated respectively. Results:The success rate(95. 92%) and the patient satisfaction rate(76%) of extraoral method group were higher than those of the intraoral method group (81. 63% and 66%);success time(3. 91 ± 0. 55)s and patient pain during treatment(3. 51 ± 0. 25) in extraoral method group were less than those in the intraoral method group[(5. 57 ± 0. 51) s and (6. 6 ± 0. 21)]. The degree of changes of SBP, DBP and HR in extraoral method group were less than those in the intraoral method group(P<0. 05). Conclusion:Extraoral manual reposi-tion approach is more effective than intraoral approach in the treatment of acute anterior dislocation of temporomandibular joint.
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Objective To investigate the clinical efficacy of heat-sensitive point moxibustion plus manipulative reduction in treating thoracic facet joint disorder. Method A single-blind randomized controlled trial was carried out. Eighty-two patients meeting the criteria were randomly allocated to an observation group of 42 cases and a control group of 40 cases. The observation group received heat-sensitive point moxibustion plus manipulative reduction and the control group, TDP plus manipulative reduction. Both groups were treated five times a week, five times as a course for a total of two courses (including the patients cured after less than two courses). The therapeutic effects were evaluated by using the McGill Pain Questionnaire the as the observation index, comparing pre-/post-treatment Pain Rating Index (PRI) scores, Visual Analogous Scale (VAS) scores and Present Pain Intensity (PPI) scores and referring to the Criteria of the Diagnosis of and the Therapeutic Effect on Syndromes in Traditional Chinese Medicine. Result After treatment, the PRI, VAS and PPI scores decreased significantly in both groups (P<0.01) and were lower in the observation group than in the control group (P<0.01). The cure rate was 57.1% (24/42) in the observation group, which was significantly higher than 27.5% in the control group (11/40,P<0.01). The total efficacy rate was 95.2% (40/42) in the observation group, which was significantly higher than 80.0% in the control group (32/40,P<0.01). Conclusion Heat-sensitive point moxibustion plus manipulative reduction has a very good therapeutic effect on thoracic facet joint disorder. The effect is significantly better than that in the control group.
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Objective To investigate the recurrence rate and recurrence risk factors of benign positional vertigo after manual reduction. Methods A total of 186 cases diagnosed with BPPV were selected as our subjects. Vertigo recurrence rate was calculated at 30 d,60 d,90 d after manual reduction. Risk factors for recurrence were analyzed using binary Logistic Regression. Results 172 cases diagnosed in BPPV patients completed 90 days follow-up. Vertigo recurrence rate was 8. 79%(16/182)in 30 days,17. 05%(30/176)in 60 days,and 22. 09%(38/172)in 90 days. The average age in recurrence patients was(59. 1 ± 10. 2)years old,significantly higher than the non-recurrent group( 47. 6 ± 7. 3 ). The recurrence rates in patients with complicated with hypertension,diabetes,hyperlipidemia,coronary heart disease were 57. 89%(22/38),60. 53%(23/38),73. 68%(28/38),39. 47%(15/38)respectively. Rise and turning neck are prone to recurrence,and recurrence rate were 16. 42%( 22/134 ),8. 21%( 11/134 ),9. 70%( 13/134 ) and 16. 42%(22/134). Recurrence rate of patients with manipulative reduction times ﹥10 times( reset multiple times before being cured)was 90. 90%( 10/11 ). Logistic regression analysis showed that the duration before manual reduction BPPV(OR=2. 631,95%CI 1. 082 -7. 572,P =0. 022)and the number of manual reduction ﹥10( OR=3. 107,95%CI 1. 205-7. 842,P=0. 018)after BPPV is manipulative reduction independent risk factor for recurrence. Conclusion Patients with BPPV in middle-aged and high seizure frequency have a high recurrence rate. Patients with BPPV complicated by hypertension,diabetes,hyperlipidemia,coronary atherosclerotic heart disease have the same higher recurrence rate. The rise and turn the neck often cause BPPV recurrence. The reduction and the number of manual reduction﹥10 are independent risk factors of recurrence of the BPPV.
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Objective To investigate the effects of nursing intervention on the rehabilitation of patients with benign paroxysmal positional vertigo (BPPV).Methods 64 BPPV patients were randomly divided into control group and observation group, with 32 cases in each group.The control group received otorhinolaryngology routine nursing, while the observation group was managed with continuously systemic nursing interventions, including manipulative re-duction, psychological nursing intervention, health education, head nursing, follow -up and family nursing interven-tion.The Hamilton Anxiety Scale (HAMA) and Hamilton Depression Rating Scale (HDRS) were applied to evaluate the intervention effects.Results Cure rate of the observation group was significantly higher than that of the control group, and recurrence rate of the observation group was obviously lower than that of the control group(p <0.05).The anxiety and depression assessment of the observation group was significantly lower than that of the control group, with statistical difference (p <0.05).Conclusion Systemic nursing intervention can effectively improve the rehabilita-tion of patients with BPPV, and reduce recurrence rate.
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Objective To investigate the value of the manipulative reduction monitored by ultrasound for the intussusception of children.Methods One hundred and three intussusception children were dynamically observed by ultrasound,and were pressed softly beginning with the head of the intussusceptum,and observed whether there was intestinal peristalsis, and whether the intussuseeptum shortened and disappeared finally.The results were analyzed based on the size of the masse, the length of the intussusceptum,and the patients' age,and compared with the X-ray high pressure air enema.Results Fifty (48.5 ％) intussusception children were recovered.The recoverability was related to the size of the mass, the length of the intussusceptum, and the age of the children (level of cooperation).Thirty-nine patients were recovered after reexamined one hour later.The recoverability of manipulative reduction monitored by ultrasound for the mass diameter less than 2.0 cm was obviously higher than that by X-ray high pressure air enema.Conclusions Manipulative reduction monitored by ultrasound could cure almost half of the intussusception children patients directly.It could decrease the number of patients who were treated with high-pressure air enema,it could relieve the pain of the children and reduce their medical expenses.It also could be acted as a screening way to other therapies like high pressure air enema.
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Objective To observe the curative effect of cervical rotating and pointing manipulation at supine position on Cervical Spondylosis (CS) based on X-ray localization diagnosis. Methods Combining the vertebra pathology shift on X-ray films with the 3-step-location diagnosis method to treat 448 CS patients by cervical rotating and pointing manipulation. Results The effective rate was 97.5%, and the improvement rate on X-ray films is 95.7%, the degree of manipulative reduction was in direct proportion to clinical effect. Conclusion Treating cervical spondylosis by Manipulative reduction based on X-ray localization diagnosis is very safe, accurate and good-effected.
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Objective To observe the clinic curative effect of the easy and prompt manipulative treatment of shoulder joint dislocation.Methods Manipulations of elbow flexion,extorsion,and/or abduction and traction reduction were used in all 253 cases.Results The total stlccessful rate of reduction Was 99.21%.Conclusion Besides the SUCCESSful rate Was high,the manipulation Was easy,labor-saving and causing little pain to patients.Therefore,this method was worthwhile being widely used in clinic.