新型下肢可调负重康复支具在股骨近端防旋髓内钉术后康复中的临床疗效  

A new type of adjustable weight-bearing rehabilitation brace for lower limbs in postoperative rehabilitation of proximal femoral nail anti-rotation

作　　者：黄砖枝[1] 陈志达 宋超[1] 吴进 蔡弢艺 林斌[1] HUANG Zhuan-zhi;CHEN Zhi-da;SONG Chao;WU Jin;CAI Tao-yi;LIN Bin(Department of Orthopaedics,the 909th Hospital of PLA,Affiliated Southeast Hospital of Xiamen University,Orthopaedic Center of People's Liberation Army,Zhangzhou 363000,Fujian,China)

机构地区：[1]中国人民解放军联勤保障部队第909医院全军骨科中心厦门大学附属东南医院,福建漳州363000

出　　处：《中国骨伤》2020年第4期306-311,共6页China Journal of Orthopaedics and Traumatology

基　　金：全军后勤科研项目(编号:CNJ16J012);漳州市科技拥军项目(编号:ZZ2017KD05);第909医院青年苗圃项目(编号:18Y003)。

摘　　要：目的:研究分析自研新型下肢可调负重康复支具在下肢股骨转子间骨折行股骨近端防旋髓内钉(proximal femoral nail anti-rotation,PFNA)术后康复中的临床疗效。方法:自2015年7月至2017年6月收治62例Ⅱ型(Evans-Jensen分型)股骨转子间骨折患者行PFNA内固定术,按随机数字法分为常规康复组30例和支具康复组32例。其中常规康复组,男11例,女19例,年龄(70.73±6.09)岁;支具康复组,男17例,女15例,年龄(71.25±6.60)岁。常规康复组患者术后按常规方法康复,支具康复组患者应用自研新型下肢可调负重康复支具辅助早期康复。记录并比较分析两组患者随访过程中的疼痛强度(VAS评分)、患肢负重情况、骨折临床愈合时间、Harris评分及并发症发生情况。结果:9例患者半年后失访,其余53例患者获得随访,时间9~18个月。支具康复组在术后1、3、6个月VAS评分均低于常规康复组(P<0.05);支具康复组在各时间点的患肢负重情况均明显大于常规康复组(P<0.05),但支具康复组的骨折临床愈合时间较常规康复组更短(P<0.05);此外,在术后支具康复组的Harris评分均优于常规康复组(P<0.05),而并发症的发生率则较常规康复组更低(P=0.048)。结论:自研新型下肢可调负重康复支具在Evans-JensenⅡ型股骨转子间骨折行PFNA内固定术后康复中能明显缓解术后疼痛,调节并适度增加骨折端应力刺激,从而促进骨折愈合,加速髋关节功能恢复,降低并发症发生率,其临床效果安全可靠。Objective:To study and analyze the clinical effect of the self-developed new adjustable weight-bearing rehabilitation brace in the rehabilitation of the femoral intertrochanteric fracture after the operation of PFNA.Methods:From July 2015 to June 2017,62 patients with typeⅡ(Evans-Jensen classification)intertrochanteric fracture of femur were treated with PFNA internal fixation.There were 11 males and 19 females in the routine rehabilitation group,with an average age of(70.73±6.09)years;17 males and 15 females in the brace rehabilitation group,with an average age of(71.25±6.60)years.Among them,the patients in the routine rehabilitation group recovered according to the routine method,and the patients in the support rehabilitation group used the self-developed new adjustable weight-bearing rehabilitation support of lower limbs to assist the early rehabilitation.The pain intensity(VAS score),weight-bearing of affected limb,clinical healing time of fracture,Harris score and complications were recorded and analyzed.Results:Nine patients lost their visit half a year later,the other 53 patients were followed up for 9 to 18 months.The VAS score at 1,3,6 months after operation of brace rehabilitation group was lower than that of routine rehabilitation group(P<0.05).The weight-bearing of the limbs in the rehabilitation group was significantly higher than that in the conventional rehabilitation group(P<0.05),but the clinical healing time of fracture in the brace rehabilitation group was shorter than that in the routine rehabilitation group(P<0.05).In addition,the Harris score of the postoperative brace rehabilitation group was better than that of the conventional rehabilitation group(P<0.05).The incidence of complications was lower than that of the conventional rehabilitation group(P=0.048).Conclusion:In the rehabilitation of Evans Jensen typeⅡintertrochanteric fracture after PFNA internal fixation,the new self-developed adjustable weight-bearing rehabilitation brace can significantly relieve postoperative pain,regulat

关 键 词：股骨骨折 髋骨折 康复 支架(骨科) 骨折固定术 髓内 

分 类 号：R683.42[医药卫生—骨科学]