Ilizarov牵伸器治疗创伤性膝关节伸直位僵硬  

Using Ilizarov distractor for treatment of knee ankylosis in extension secondary to trauma

作　　者：梁超[1] 刘跃华[1] 史鹏飞[1] 李军伟[1] 郑冰[1] 董帅 李海乐 

机构地区：[1]河南漯河市中心医院创伤骨科,漯河462000

出　　处：《中国矫形外科杂志》2018年第5期463-467,共5页Orthopedic Journal of China

摘　　要：[目的]探讨Ilizarov牵伸器治疗创伤性膝关节伸直位僵硬的临床效果,并同膝关节软组织松解联合CPM机锻炼进行比较。[方法]2012年3月～2017年3月因膝关节周围骨折术后发生关节伸直位僵硬在漯河市中心医院创伤骨科住院治疗的患者共22人,分为Ilizarov牵伸器治疗组12例(Ilizarov组),膝关节软组织松解联合CPM锻炼组10例(松解组)。记录术前术后膝关节最大屈曲度、术后自主屈曲活动度达到60°所用时间、膝关节功能优良率等数据,对比分析两组患者的临床效果。[结果]Ilizarov组术后膝关节最大屈曲度为(102.87±1.84)°;松解组为(85.45±2.24)°,差异有统计学意义(P<0.05)。Ilizarov组术后自主屈曲活动度达到60°所用时间为(28.50±0.71)d,松解组为(61.36±3.46)d,差异有统计学意义(P<0.05)。参照Judet疗效评定法对膝关节功能进行评定,Ilizarov组优7例,良3例,可2例,优良率为83.3%;松解组优2例,良3例,可5例,优良率为50%。[结论]Ilizarov牵伸器治疗创伤性膝关节僵直具有治疗时间短、术后膝关节活动功能好等优点,是治疗膝关节僵直的有效方法。[Objective] To investigate the clinical outcomes of using Ilizarov distractor for treatment of knee ankylosis in ex- tension secondary to trauma, by comparing with those of soft tissue knee release combined with continuous passive motion （CPM）. [Methods] From March 2012 to March 2017, 22 patients with knee ankylosis in extension secondary to trauma were sur- gically treated in Luohe Central Hospital, including 12 patients received Ilizarov distractor treatment （the Ilizarov group）, and the remaining 10 patients who underwent soft tissue release combined with CPM （the release group）. The maximal knee flexion, the time elapsed to regain spontaneous flexion up to 60% and the excellent rate of knee function were compared between the two groups. [Results] At the latest follow up, the maximal knee flexion was recorded （102.87± 1.84）° in the Ilizarov group, whereas （85.45±2.24）° in the release group, showed a statistically significant difference between them （P〈0.05）. The time elapsed to re- gain spontaneous flexion up to 60° proved （28.50±0.71） days in the Ilizarov group, while （61.36~3.46） days in the release group, with a statistically significant difference between the two groups （P〈0.05）. According to the Judet assessment system, the knee function in the Ilizarov group was graded as excellent in 7, good in 3, fair in 2, with the excellent and good rate of 83.3%, by con- trast, in the release group, excellent in 2, good in 3 and fair in 5, associated with the excellent and good rate of 50%. [Conclu- sion] Ilizarov distractor for treatment of knee ankylosis secondary to trauma with advantages of shortened treatment time and im- proved knee function is an effective method.

关 键 词：Ilizarov牵伸器 膝关节伸直位僵硬 活动度 软组织松解 

分 类 号：R687.4[医药卫生—骨科学]