不同时机综合康复治疗对膝关节周围骨折术后膝关节挛缩的疗效分析  

Research for the effects of different phases of comprehensive rehabilitation therapy on trauatic knee joint contracture after operation of fracture around the knee joint

作　　者：张全兵[1] 周云[1] 王锋[1] 刘奕[1] 冯小军[1] 丁呈彪[1] 王永召[1] ZHANG Quan-bing;ZHOU Yun;WANG Feng(Department of rehabilitation,the second of affiliated hospital of Anhui university,Anhui,Hefei 230601)

机构地区：[1]安徽医科大学第二附属医院康复医学科,安徽合肥230601

出　　处：《中国伤残医学》2020年第17期7-10,共4页Chinese Journal of Trauma and Disability Medicine

基　　金：安徽医科大学校科研基金项目(编号:2018xkj050)。

摘　　要：目的:分析和研究不同时机综合康复治疗对膝关节周围骨折术后膝关节挛缩的预防和治疗疗效.方法:选取2014年1月-2018年12月安徽医科大学第二附属医院收治的膝关节周围骨折患者52例,其中男性40例,女性12例;年龄10-69岁.3组患者入住我科前均已行骨折内固定,骨折固定牢靠.根据骨折术后综合康复治疗的时间分为3组.A组:16例,其中男性13例,女性3例,年龄16-62岁,平均年龄(39.31±15.30)岁;骨折术后1个月内由骨科转入康复医学科行康复治疗,或骨折术后1个月内因遗留有膝关节功能障碍直接行康复治疗.B组:18例,其中男性13例,女性5例;年龄10-55岁,平均年龄(36.33±13.27)岁;骨折术后早期未进行综合康复治疗,术后1-3个月因存在有膝关节活动功能障碍来康复医学科就诊.C组:18例,其中男性14例,女性4例;年龄24-69岁,平均年龄(39.78±10.67)岁;骨折术后早期未进行综合康复治疗,术后3个月以后因存在膝关节活动功能障碍来康复医学科就诊.3组患者根据各自相应的疾病阶段特点予以相应的康复治疗措施.对3组患者进行综合康复治疗前、行6个疗程综合康复治疗后的膝关节主动活动度、适用于一般膝关节损伤患者的疗效评分系统、临床治疗疗效标准对治疗疗效进行综合评估.结果:所有患者骨折均愈合良好,康复治疗未对骨折解剖位置、骨折愈合情况等产生不良影响.治疗前,3组患者膝关节活动度分别是37.56°±19.31°、39.89°±12.97°、41.22°±16.33°,适用于一般膝关节损伤患者的疗效评分分别是(44.69±13.40)分、(47.50±13.82)分、(49.33±13.95)分.综合康复治疗前3组患者膝关节活动度、适用于一般膝关节损伤患者的疗效评分差异无统计学意义(P>0.05);经过6个疗程综合康复治疗后,3组患者的膝关节活动度分别是109.94°±16.33°、96.06°±9.56°、69.22°±13.99°,3组患者适用于一般膝关节损伤患者的疗效评分分别是Objective:To investigate the effects of different phases of comprehensive rehabilitation therapy on traumatic knee joint contracture after operation of bone fracture around the knee joint.Methods:From January 2014 to December 2018,52 patients with bone fractures around the knee joint were selected from Depsirtment of Rehabilitation Medicine of the Second Affiliated Hospital of Anhui Medical University,which included 40 males and 12 females,aged 10-69 years.All patients in the 3 groups had received internal fixation for fracture before admission to our department,and the fracture fixation was solid.The patients was divided into 3 groups according to the comprehensive rehabilitation time.Group A:Sixteen patients were included in the group,which included 13 males and 3 females,aged 16-62 years,and the average age was 39.31±15.30.The patients were transferred from the orthopaedic department or hospitalized due to the dysfunction of knee joint activities before 1 month postoperatively.Group B:Eighteen patients were included in the group,which included 13 males and 5 females,aged 10-55 years,and the average age was 36.33±13.27.The patients were not given comprehensive rehabilitation therapy at the early stage after operations of bone fractures and hospitalized due to the dysfunction of knee joint activities in 1-3 months postoperatively.Group C:Eighteen patients were included in the group,which included 14 males and 4 females,aged 24-69 years,and the average age was 39.78±10.67.The patients were not given comprehensive rehabilitation therapy at the early stage after operation of bone fractures and hospitalized due to the dysfunction of knee joint activities after 3 months postoperatively.All patients were given comprehensive rehabilitation therapy according to their respective disease phase characteristics.The ranges of motion,the clinical efficacy evaluation standard and the knee efficacy score were studied and compared before comprehensive rehabilitation and after 6 courses of comprehensive rehabilitation.Results:

关 键 词：膝关节 骨折 关节挛缩 康复治疗 关节功能 

分 类 号：R493[医药卫生—康复医学]