To evaluate the clinical efficacy of"dynamic and static combination"of shaking,pulling and poking ma-nipulation of lateral malleolus combined with brace fixation in the treatment of Hepple type Ⅰ-Ⅲ OLT
10.3969/j.issn.1006-5725.2025.14.013
- VernacularTitle:外踝摇拔戳手法联合支具固定"动静结合"治疗Hepple Ⅰ—Ⅲ型距骨骨软骨损伤的临床疗效
- Author:
Shulong WANG
1
;
Dongxiao LI
;
Huan LIANG
;
Ruizheng ZHU
;
Junde WU
;
Xuyue PAN
;
Zhanhua MA
;
Yinze QI
;
Feng ZHAO
;
Ayong HUANG
;
Zhimin YANG
;
Zhaojun CHEN
Author Information
1. 北京中医药大学第三临床医学院(北京 100029);解放军总医院第六医学中心中医医学部骨伤科(北京 100048)
- Publication Type:Journal Article
- Keywords:
osteochondral lesion of the talus;
shaking,pulling and poking manipulation;
dynamic and static combination
- From:
The Journal of Practical Medicine
2025;41(14):2210-2216
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical efficacy of the"dynamic and static combination"approach in the treatment of Hepple Ⅰ-Ⅲ type osteochondral lesions of the talus(OLT),utilizing external ankle shaking,pulling,and poking manipulations in conjunction with ankle brace fixation.Methods A total of 82 patients diagnosed with OLT,who sought treatment at four hospitals between June 2022 and December 2023,were included in the study.Both the experimental and control groups received ankle immobilization using braces through-out the treatment period.The control group was administered Voltaren Emulgel topically twice daily(morning and evening),with each treatment course lasting 30 days,for a total of one course.The experimental group received additional therapeutic intervention involving shaking,pulling,and poking manipulations,conducted twice weekly,with the same duration and number of treatment courses as the control group.Follow-up assessments were scheduled at 2 weeks,4 weeks,and 2 months post-treatment.Outcome measures included the pain rating index(PRI),visual analogue scale(VAS)for pain intensity,current pain intensity(PPI),American Orthopaedic Foot & Ankle Society(AOFAS)ankle and hindfoot scores,proprioceptive function,and the size of OLT.Results During the longitudinal assessment conducted at 2-week,4-week,and follow-up intervals,the experimental group exhibited superior clinical outcomes compared to the control group,with statistically significant decreases in PRI,PPI,and AOFAS scores(all P＜0.05).VAS scores showed progressive improvement over time,with significant intergroup differences observed at both the 4-week and follow-up assessments(P＜0.05).Biomechanical analysis performed post-intervention indicated improved kinematic repositioning accuracy in the experimental group,as reflected by significantly reduced active-passive error angles(P＜0.05).Importantly,measurements of OLT area revealed notable therapeutic effects in the experimental group(P＜0.05),whereas no statistically significant changes were observed in the control group throughout the study period(all P＞0.05).Conclusions Under the guidance of the"dynamic and static combination"concept,the integration of shaking,pulling,and poking manipu-lation with conventional Western medicine-based conservative treatment for OLT demonstrates more pronounced advantages in alleviating pain,improving ankle joint function,restoring proprioception,facilitating lesion recovery,and enhancing overall quality of life.
