早期康复训练对儿童不稳定性肱骨髁上骨折经皮克氏针固定术后肘关节功能恢复的疗效观察  

Effect of early rehabilitation training on elbow joint function recovery after percutaneous Kirschner wire fixation of unstable supracondylar fracture of humerus in children

作　　者：孙银梅[1] 王辞山 郭学德[1] 孟红亚 张曼 杜鹃 Sun Yinmei;Wang Cishan;Guo Xuede;Meng Hongya;Zhang Man;Du Juan(Department of Trauma,Bozhou People's Hospital,Anhui,Bozhou 236800,China)

机构地区：[1]亳州市人民医院创伤骨科,安徽亳州236800

出　　处：《中国医学前沿杂志（电子版）》2021年第8期5-9,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：2015年国家卫生计生委医药卫生科技发展研究项目(W2015QJ058)。

摘　　要：目的分析早期康复训练对儿童不稳定性肱骨髁上骨折经皮克氏针固定术后肘关节功能恢复效果的影响。方法选取2017年2月至2020年2月亳州市人民医院收治的142例不稳定性肱骨髁上骨折患儿纳入本研究。使用随机数字表法将入选患儿分别纳入早期康复组和常规康复组,每组各71例,均予经皮克氏针固定治疗,常规康复组患儿术后石膏拆除后行康复训练,早期康复组患儿术后1 d即开始进行早期康复训练。对比两组患儿术后疼痛情况、骨折愈合时间、肘关节功能优良率。结果共有136例患儿随访时间≥14 d,将其纳入结果分析,其中,早期康复组69例患儿获得有效随访,常规康复组67例患儿获得有效随访。两组患儿术后1 d、7 d、14 d视觉模拟评分法(visual analogue scale,VAS)评分均显著低于本组术毕(均P<0.05),早期康复组患儿术后7 d和14 d VAS评分均显著低于同期常规康复组(均P<0.05)。早期康复组患儿骨折愈合时间显著短于常规康复组(P<0.05),术后并发症发生率显著低于常规康复组(P<0.05)。两组患儿术后14 d Mayo评分均显著高于本组术后1 d(均P<0.05),早期康复组患儿术后14 d Mayo评分、患肢肘关节功能优良率均显著高于常规康复组(均P<0.05)。结论儿童不稳定性肱骨髁上骨折术后早期开展康复训练有助于减轻患儿疼痛、促进骨折愈合、改善肘关节功能,且安全性良好。Objective To analyze the effect of early rehabilitation training on elbow joint function recovery after percutaneous Kirschner wire fixation of unstable supracondylar fracture of humerus in children.Method A total of 142 children with unstable supracondylar fracture of humerus who were admitted to Bozhou People's Hospital from February 2017 to February 2020 were included in the study.The enrolled children were included into early rehabilitation group and routine rehabilitation group according to the random number table method,with 71 cases in each group.They were treated with percutaneous Kirschner wire fixation.Routine rehabilitation group children received rehabilitation training after plaster removed,and early rehabilitation group children started early rehabilitation training one day after operation.The postoperative pain,fracture healing time and the excellent and good rate of elbow joint function were compared between the two groups.Result A total of 136 children were followed up for≥14 days and included in the result analysis.Among them,69 children in early rehabilitation group were effectively followed up,and 67 children in routine rehabilitation group were effectively followed up.The visual analogue scale(VAS)scores on the 1st,7th and 14th day after operation in the two groups were significantly lower than those after operation(all P<0.05).The VAS scores on the 7th and 14th day after operation in early rehabilitation group were significantly lower than those in routine rehabilitation group(all P<0.05).The fracture healing time of children in early rehabilitation group was significantly shorter than that in routine rehabilitation group(P<0.05),and the incidence of postoperative complications was significantly lower than that in routine rehabilitation group(P<0.05).The Mayo scores on the 14th day after operation in the two groups were significantly higher than those on the 1st day after operation in this group(all P<0.05).The Mayo score and excellent and good rate of elbow joint function on the 14th day

关 键 词：康复训练 不稳定性肱骨髁上骨折 经皮克氏针固定 肘关节功能 

分 类 号：R726.8[医药卫生—儿科]