Application of health management mode based on WeChat platform in postoperative rehabilitation of patients with tibial plateau fractures

Abstract

Objective To explore the effect of Wechat platform health management on postoperative rehabilitation in patients with tibial plateau fractures (TPF). Methods A total of 120 patients with TPF admitted to War-Trauma Emergency Center, Changhai Hospital, Navy Military Medical University from January 2014 to December 2016 were enrolled in this study. Patients were divided into WeChat group and control group with random number table method, 60 patients in each group. The WeChat group was used to perform point-to-point and point-to-face three-dimensional stereotactic management using the WeChat grouping model; the control group of the patients who were used for routine outpatient follow-up guidance. The intervention time of two groups both were 10 months. Patients with long-term complications of joint stiffness, traumatic arthritis were observed and objectively evaluated. The data were processed with chi-square test. Before and after intervention, Rasmussen clinical grade score was performed on the two groups of patients. The assessment included function, pain, range of motion, flexion deformity, muscle strength, and stability; disease knowledge, treatment emphasis, executive compliance, daily activity improvement, anxiety stress, postoperative recovery satisfaction were investigated. The data were processed with t test. Results WeChat group patients had long-term postoperative complications of joint stiffness and traumatic arthritis(5 and 3 cases), which were significantly lower than control group (12 and 8 cases) (χ2=3.358, 2.502; with P values below 0.05). Before the intervention, there were no significant differences in Rasmussen clinical grade scores between the two groups. Rasmussen clinical grade scores in the control group patients after intervention were higher than those before intervention(with P values below 0.05). The score of functional, pain, range of motion, flexion deformity, muscle strength and stability in Rasmussen clinical grade score of WeChat group patients after intervention were (16.89±4.14), (24.33±4.42), (13.93±3.12), (7.17±2.42), (7.12±2.54) and (7.15 ± 2.59) points respectively, were significantly higher than those before intervention [(6.78±2.82), (5.78±1.87), (5.84±1.97), (2.71±1.09), (2.67±1.02) and (2.45±0.88) points], the differences were statistically significant (t=39.739, 19.841, 14.462, 12.129, 20.571, 9.676; with P values below 0.05). The scores were also significantly higher than those after intervention in control group [(12.91±3.12), (20.76±3.92), (10.78±2.83), (5.78±1.82), (5.65±1.78) and (5.62±1.82) points], the differences were statistically significant (t=4.657, 3.199, 3.486, 2.798, 2.049, 2.506; P<0.05, =0.003, 0.001, 0.008, 0.047, 0.017). In addition, before intervention, there were no statistically significant differences in the evaluation of living standards between the two groups. The control group had lower evaluation of living standards after intervention than before intervention. The scores of disease awareness, treatment emphasis, execution order, improvement of daily activities, anxiety and postoperative recovery satisfaction in WeChat group were (1.01±0.32), (0.78±0.22), (1.12±0.13), (1.04±0.21), (0.76±0.12) and (1.06±0.14) points respectively, were lower than those before intervention [(3.01±0.82), (2.89±0.79), (3.21±0.62), (2.99±0.71), (3.21±0.63) and (3.10±0.76) points], the differences were statistically significant (t=15.667, 17.899, 18.006, 11.103, 13.516, 10.376; with P values below 0.05). The scores were also significantly lower than those of the control group after intervention [(2.13±0.42), (1.89±0.62), (1.89±0.31), (1.68±0.46), (1.64±0.33) and (1.88±0.34) points]. The differences were statistically significant (t=8.542, 5.060, 10.376, 4.819, 5.940, 9.000; with P values below 0.05). Conclusions WeChat management has a positive impact on health management of patients. It can reduce postoperative long-term complications, improve knee joint function and improve life quality of patients. Key words: Tibial fractures; Rehabilitation; Health records, personal; WeChat