肘部骨折术后功能锻炼的时机选择  

Choice of Training Time for Patients with Elbow Fracture after Surgery

作　　者：李琪[1] 李豹[1] 林光锚[1] 杨国敬[1] 胡顺富[1] 马江燕[1] 林瑞新[1] 蔡春元[1] 刘敏[1] 

机构地区：[1]温州医学院附属第三医院,浙江温州325200

出　　处：《中国中医骨伤科杂志》2011年第9期36-37,共2页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：浙江省中医药科学研究基金计划2010ZB140;温州市医药卫生科研项目2010B087

摘　　要：目的：研究肘部骨折术后功能锻炼的时机。方法：于2009年5月~2010年4月在我院收集肘部骨折患者60例并随机分为2组。A组30例,其中男12例,女18例;年龄23~63（43.54±7.75）岁。B组30例,其中男11例,女19例;年龄24~67（46.13±6.21）岁。A组术后即开始有步骤的功能锻炼;B组于术后3周末开始门诊康复科功能锻炼。2组最后在术后6个月复查时,进行Mayo肘关节功能评分（包括肘关节活动度）,以及安全性评定（X线复查包括骨折移位、内固定失效、异位骨化等方面）。结果：术后6个月Mayo评分A组（91.00±7.81分）优于B组（76.83±10.71分）（t=5.86,P〈0.05）。其中肘关节屈伸活动度,A组（102.41±9.15）°优于B组（83.57±6.21）°（P〈0.05）。两组经每次X线复查除A组中有1例关节外未行固定的撕脱的骨块位置有微小变化外,其余未发现内固定松脱、骨折移位、异位骨化等现象;提示A组功能锻炼整个过程是安全的。结论：肘部骨折术后早期进行功能锻炼是安全的,有利于肘关节功能的恢复。Objective：To investigate the optimal time for functional exercise of the patients with elbow fracture after surgery.Methods：From May 2009 to April 2010,60 patients of elbow fracture were randomly divided into two groups（30 cases in each group）.Group A included 12 male and 18 female,aged 23 to 63 years old（average 43.54）.While,group B included 11 male and 19 female,aged 24 to 67 years old（average 46.13）.Patients of group A started functional exercises with measured strokes as early as possible after surgery.While patients of group B were started functional exercises three weeks after surgery in outpatient rehabilitation department.Mayo Elbow Performance Score,including range of motion of elbow joint,and security（using X-ray to recheck displacement fracture,internal fixation failure,and heterotopic ossification） were evaluated 6 months after operation.Results：Mayo score of group A（91.00±7.81） were priority to group B（76.83±10.71,t=5.86,P0.05）.The range of elbow motion in group A（102.41±9.15 degrees） were priority to group B（83.57±6.21 degrees,t=9.33,P0.05）.There was no inner fixation failure,displacement fracture,and heterotopic ossification in two groups,except one case whose bone fragment of extra-articular avulsion was not fixed with small changes in position in X-ray review of A group.It indicated the functional exercise was safe throughout the process.Conclusion：The early exercise is safe and benefit for the recovery of the elbow joint function for patients with elbow fracture after surgery.

关 键 词：肘关节僵硬 骨折 功能锻炼 

分 类 号：R683.41[医药卫生—骨科学]