髋臼骨折Kocher-Langenbeck入路术后等速肌力测试:36例患肢髋关节周围力量分析  

Muscle strength test of acetabular fracture patients following Kocher-Langenbeck posterior approach surgery:Peri-hip power analysis in 36 cases

作　　者：汤文杰[1] 王满宜[1] 朱仕文[1] 

机构地区：[1]北京大学第四临床医学院创伤骨科,北京市100035

出　　处：《中国组织工程研究与临床康复》2008年第44期8666-8668,共3页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：2001-01/2005-12北京积水潭医院创伤骨科行Kocher-Langenbeck入路手术的髋臼骨折患者36例,均在术前行胫骨结节或股骨髁上骨牵引,排除术后X射线片有创伤性关节炎表现、其他下肢合并损伤。应用Biodex多关节肌肉等速训练与测试系统,对患肢及健侧髋关节的外展肌群、后伸肌群在60(°)/s慢速和180(°)/s快速条件下进行等速肌力测试对比,采用可信度较高的峰力矩、总作功、平均功率等指标予以评估,两侧肌力差异≤10%为正常,≥20%为异常,11%～19%为可疑异常。结果快速测试数值显著大于相应的慢速测试数值(t=2.21,P<0.05),后伸肌群肌力的改变要显著大于外展肌群肌力的改变(t=4.33,P<0.05),提示髋臼骨折Kocher-Langenbeck入路手术中应加强对后伸肌群主要是臀大肌的保护,尽量减少其损伤,并保护肌肉血运,术后应侧重加强肌肉耐力的康复训练。Thirty-six patients with acetabular fracture undergoing Kocher-Langenbeck approach surgery in Beijing Jishuitan Hospital between January 2001 and December 2005 were selected. All patients underwent tibial tubercle or femoral upper condyle traction before surgery. People with traumatic arthritis or other lower limb injury on postoperative X-ray were excluded. Using Biodex system to test the abduction and extension muscle at 60 （ ° ）/s and 180 （° ）/s. Peak torque, total work, and mean power were used for evaluation. The difference between bilateral limbs ≤ 10% was normal, ≥ 20% was abnormal and 11%-19% was suspected. The muscle strength in fast test was more than the slow test （t=2.21, P 〈 0.05）, and the muscle strength reduce of abduction was less than that of extension in the posterior approach operation ofthe acetabular fracture （t=4.33, P 〈 0.05）, indicating we should pay more attention to protect the extension muscles during Kocher-Langenbeck surgery and guide the patients to do more exercises to recover the endurance of extension muscle.

关 键 词：髋臼骨折 肌力 后方入路 

分 类 号：R681[医药卫生—骨科学]