肘关节骨折术后早期康复的临床疗效观察  

The clinical efficacy of early rehabilitation after internal fixation of the elbow fracture

作　　者：曹晶晶[1] 唐金树[2] 周谋望[3] 吴新宝[4] 朱加亮[2] 吕艳伟[4] 李涛[3] 石秀秀[2] 孙海燕[2] 吴金玲[2] 胡鸢[2] 秦江[2] 李淳德[5] 王宁华[5] 谢欲晓[6] 林朋[6] 李中实[6] 海涌[7] 赵会[7] 薛庆云[8] 顾新[8] 马华松[9] 陆明[9] 马远征[10] 李大伟[10] 侯树勋[2] 

机构地区：[1]辽宁医学院解放军总医院第一附属医院研究生培养基地,北京100048 [2]解放军总医院第一附属医院,北京100048 [3]北京大学第三医院,100083 [4]北京积水潭医院,100035 [5]北京大学第一医院,100034 [6]中日友好医院,北京100029 [7]首都医科大学附属北京朝阳医院,北京100020 [8]北京医院,100730 [9]解放军第306医院,北京100101 [10]解放军第309医院,北京100091

出　　处：《中国骨与关节杂志》2016年第3期194-198,共5页Chinese Journal of Bone and Joint

基　　金：北京市科技计划项目(D13110700490000);北京市科技计划课题(D131100004913003)

摘　　要：目的观察肘关节骨折术后早期康复的临床疗效。方法 2013年6月至2015年3月,我院收治肘关节骨折患者101例,其中男55例,女46例;年龄13~85岁,平均（41.79±16.99）岁;依据国际内固定研究学会AO分型,A型18例,B型21例,C型62例;根据闭合性骨折的Tscherne软组织损伤分型：C0 15例、CI 31例、CII 34例、CIII 21例。所有患者均采取切开解剖复位内固定手术治疗,术后采用随机数字表法将患者分为观察组（n=51）和对照组（n=50）,观察组在术前进行康复宣教,术后即进入康复期,由康复医师以及治疗师进行康复指导;对照组术后早期未介入康复,待骨折稳定后自行锻炼。术后12、24周分别评定肘关节视觉模拟评分（visual analague scale,VAS）、活动度（range of motion,ROM）、HSS（hospital for special surgery）功能评分;对所有的数据进行整理和统计学分析。结果本组随访24周,VAS评分：术后12周,观察组（1.24±1.46）分,对照组（1.22±1.23）分,差异无统计学意义（P〉0.05）;术后24周,观察组（0.53±0.95）分,对照组（0.84±1.15）分,差异无统计学意义（P〉0.05）。肘关节ROM：术后12周,观察组（104.27±21.96）°,对照组（88.98±30.51）°,差异有统计学意义（P〈0.01）;术后24周,观察组（117.84±26.06）°,对照组（105.40±31.85）°,差异有统计学意义（P〈0.05）。肘关节HSS功能评分：术后12周,观察组（80.08±16.67）分,对照组（69.02±18.62）分,差异有统计学意义（P〈0.01）;术后24周,观察组（89.71±8.90）分,对照组（81.56±18.07）分,差异有统计学意义（P〈0.01）。结论肘关节骨折术后康复治疗的早期介入能改善患者肘关节的功能及预后,但肘关节的疼痛缓解与康复开始的时间无关。Objective To investigate the clinical efficacy of early rehabilitation after the internal fixation of the elbow fracture. Methods From June 2013 to March 2015, 101 elbow fracture patients were admitted in our hospital. There were 55 males and 46 females with the average age of（ 41.79 ± 16.99） years（ range： 13- 84 years）. According to the international society for the research of internal fixation with Association for the study of Internal Fixation（ AO） classification： 18 cases were of type A, 21 B, 62 C. According to Tscherne closed fracture and soft tissue injury classification： 15 cases were of C0, 31 CI, 34 CII, 21 CIII. A total of 101 cases of the elbow fracture underwent open reduction and internal fixation. All were randomly divided into the observation group（ n = 51） and control group（ n = 50）. The observation group received preoperative rehabilitation education, and postoperative early rehabilitation under the help of therapists. The control group did not receive any early postoperative rehabilitation, and had routine exercises for stability. After 12, 24 weeks, assessment was made by visual analague scale（ VAS）, range of motion（ ROM） and hospital for special surgery（ HSS）. The relevant data were collected and analyzed. Results All cases had been followed up for 24 weeks. VAS scores： after 12 weeks, the observation group（ 1.24 ± 1.46） points and control group（ 1.22 ± 1.23） points, no statistical significance（ P〈0.05）; after 24 weeks, the observation group（ 0.53 ± 0.95） points and control group（ 0.84 ± 1.15） points, no statistical significance（ P〈0.05）. Elbow ROM： after 12 weeks, the observation group（ 104.27 ± 21.96） and control group（ 88.98 ± 30.51）, statistically significant（ P〈0.01）; after 24 weeks, the observation group（ 117.84 ± 26.06） and control group（ 105.40 ± 31.85）, statistically significant（ P〈0.05）. HSS elbow score： after 12 weeks, the observation group（ 80.08 ± 16.67） points and c

关 键 词：肘关节 骨折 康复 疼痛 手术后 

分 类 号：R687.3[医药卫生—骨科学]