| 刘芳,沙蕉,偶鹰飞,顾茜.术后早期应用静态进展性牵伸治疗对股骨中下段骨折患者膝关节功能的影响[J].中国康复,2018,33(6):482-485 |
| 术后早期应用静态进展性牵伸治疗对股骨中下段骨折患者膝关节功能的影响 |
| Effects of early application of static progressive stretch therapy on function of knee joint in patients with femoral lower-middle section fracture |
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| DOI： |
| 中文关键词: 静态进展性牵伸 股骨中下段骨折 疼痛 关节活动度 |
| 英文关键词: Static progressive stretch Femoral lower-middle section fracture Pain Range of motion |
| 基金项目:苏州市科技发展计划（SYSD2015038） |
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| 中文摘要: |
| 目的：观察术后早期应用静态进展性牵伸治疗对股骨中下段骨折患者膝关节功能的影响。方法：选取在我院接受内固定手术的股骨中下段骨折患者48例，随机分为观察组和对照组各24例。术后3天，2组患者均采用物理因子治疗、CPM、运动功能训练等常规康复治疗，观察组在此基础上应用IK膝关节牵伸系统进行静态进展性牵伸治疗。分别于治疗前、术后4周和术后12周对2组患者进行疼痛视觉模拟评分（VAS)和膝关节主动关节活动度测量(AROM)；于术后24周对2组患者用特种外科医院膝关节评分(HSS)评估膝关节功能、X线检查评估骨折愈合情况。结果：术后4及12周后，2组患者VAS评分均较治疗前呈明显下降趋势（均P＜0.05，0.01），且低于同时间点对照组（均P＜0.05）。术后4及12周后，2组患者AROM均较治疗前呈明显增加趋势（均P＜0.05）；术后4周2组组间比较差异无统计学意义，术后12周观察组患者AROM明显高于同时间点对照组（P＜0.05）。术后24周，观察组患者HSS评分明显高于对照组（P＜0.05）。术后24周，2组患者X线检查均有骨痂通过骨折线，患肢无纵向扣击痛，不扶拐能行走3min，对比之前X线片骨折无变形，内固定无松动开裂，无骨不连发生。结论：对股骨中下段骨折患者，术后早期应用静态进展性牵伸治疗可有效缓解疼痛，扩大膝关节主动活动范围，提高膝关节功能，且不增加骨不连风险。 |
| 英文摘要: |
| Objective: To observe the effects of early application of static progressive stretch therapy on the function of knee joint in patients with femoral lower-middle section fracture. Methods: Forty-eight patients with femoral lower-middle section fracture who underwent internal fixation in our hospital were randomly divided into observation group and control group, with 24 cases in each group. Three days after surgery, the two groups of patients were treated with physical factor therapy, CPM, motor function training and other conventional rehabilitation treatments. The observation group was given the IK knee joint stretching system for static progressive stretch therapy additionally. Visual analogue scale (VAS) and knee joint active range of motion (AROM) were assessed before, and 4 and 12 weeks after surgery. Twenty four weeks after surgery, the hospital for special surgery knee score (HSS) was used to evaluate knee function and X-ray examination to assess fracture healing. Results: At 4th and 12th week after surgery, the VAS scores in the two groups were significantly lower than those before treatment (P<0.05, 0.01), and those in the observation group were significantly lower than in the control group (P<0.05). At 4th and 12th week after surgery, the knee joint AROM in the two groups showed a significant increase as compared with that before treatmente (P<0.05). There was no significant difference in the knee joint AROM between the two groups at 4th week after surgery. At 12th week after surgery, the knee joint AROM in the observation group was significantly greater than that in the control group. At 24th week after surgery, the HSS score in the observation group was significantly higher than that in the control group (P<0.05). At 24th week after surgery, the X-ray examination revealed that there were osteophytes through the fracture line in the two groups. There was no longitudinal buckle pain in the affected limb, and patients could walk for 3 min under no crutches. Compared with the X-ray examination before surgery, there was no deformation, no loosening and internal cracking, and no bone nonunion occurred. Conclusion: For patients with femoral lower-middle section fracture, the early postoperative application of static progressive stretch therapy can effectively relieve pain, expand the AROM in the knee joint, improve the function of the knee joint, and do not increase the risk of bone nonunion. |
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