DYNAMICS OF INDICATORS OF THE ORTHOPEDIC STATUS OF THE UPPER EXTREMITY IN PATIENTS WITH THE CONSEQUENCES OF A GUNSHOT POLYSTRUCTURAL FOREARM BONES FRACTURES UNDER THE INFLUENCE OF HAND THERAPY

Abstract

Purpose: to evaluate the effectiveness of the program of hand therapy on the parameters of the orthopedic status of the upper limb in the injured with the consequences of a gunshot polystructural fracture of the bones of the forearm in the post-immobilization period Material. In the process, 49 soldiers with the consequences of a gunshot polystructural fracture of the bones of the forearm were examined. The comparison group (23 people) underwent rehabilitation according to general polyclinic principles. The main group (26 people) consisted of patients undergoing rehabilitation using the tools and principles of hand therapy (therapeutic exercises and functional training for the hand and fingers, forearm, shoulder, all joints of the upper limb, use of the "MAPS THERAPY" table; massage of the upper limb; kinesiological taping; position treatment with orthoses) lasting 1 month. The effectiveness of the program was assessed by the presence and degree of pain (by VAS), the results of goniometry, dynamometry. Results. In the injured with the consequences of a polystructural fracture of the forearm bones in the post-immobilization period, a pain syndrome in the area of the injury, limitation of the amplitude of movements in the radio-carpal and elbow joints, and a decrease in the strength of the wrist, which are factors in the disruption of the normal functioning of the upper limb, were found. After the rehabilitation intervention, a decrease in the intensity of pain at rest and during movements was found in all examined persons, there was an improvement in the amplitude of movements in the joints, and the strength of the wrist increased. According to all studied parameters, the patients of both groups showed a statistically significantly better result compared to the initial data (p<0.05), however, individuals of the main group showed a better result than the patients of the comparison group (p<0.05). Conclusions. The hand therapy program demonstrated a statistically significantly better effect (p<0.05) on all the studied indicators in comparison with the polyclinic rehabilitation program, which confirms the need for the use in patients with injuries of the upper limb of specialized directions of recovery that take into account the anatomical and physiological features of the upper limb and its a significant role in the implementation of activities of everyday life.