Kaltenborn关节松动术在踝关节骨折术后康复中的应用  

Application of Kaltenborn joint mobilization in postoperative rehabilitation of ankle joint fractures

作　　者：徐付国 冯仕明[2] 姜效韦 张明[1,2] 周敬杰 朱伟伟[2] 张杨梅 XU Fuguo;FENG Shiming;JIANG Xiaowei(Xuzhou Rehabilitation Hospital Affiliated to Xuzhou Medical University(Xuzhou Rehabilitation Hospital),Xuzhou,Jiangsu,221003,China)

机构地区：[1]徐州医科大学附属徐州康复医院徐州市康复医院,江苏徐州221003 [2]徐州市中心医院徐州医科大学徐州临床学院,江苏徐州221009

出　　处：《实用手外科杂志》2024年第3期303-305,377,共4页Journal of Practical Hand Surgery

基　　金：国家自然科学基金资助项目(项目编号:81502435);江苏省自然科学基金面上项目(项目编号:BK20201153);徐州市临床技术骨干研修计划项目(项目编号:2019GG003);徐州医科大学附属医院发展基金项目(项目编号:XYFY2021035)。

摘　　要：目的探讨Kaltenborn关节松动术对踝关节骨折术后踝关节功能障碍的改善情况。方法选取2020年7月-2022年12月收治的踝关节骨折术后踝关节功能障碍患者42例,随机分为观察组及对照组,每组各21例。对照组采用常规综合康复疗法,包括中医推拿手法、功能性电刺激、超声波、干扰电、中药熏药治疗、斜板站立;观察组在此基础上辅以Kaltenborn关节松动术。两组每周治疗5 d,连续治疗10周。分别于治疗前和治疗10周后,由同一治疗师评估主动踝关节活动范围和美国足踝外科协会(AOFAS)踝-后足量表得分,并进行分析。结果治疗前两组患者的一般资料、主动踝关节活动范围和踝关节AOFAS评分差异无统计学意义(P>0.05)。治疗后,两组患者的踝关节背伸角度较治疗前显著改善(P<0.05),且观察组优于对照组(P<0.05);两组患者的跖屈角度较治疗前显著改善(P<0.05),组间比较差异无统计学意义(P>0.05);两组患者AOFAS评分较治疗前显著改善(P<0.05),且观察组优于对照组(P<0.05)。结论Kaltenborn关节松动术可显著改善踝关节骨折术后踝关节功能障碍。Objective To observe the improvement of ankle dysfunction after Kaltenborn joint mobilization for patients after surgery of ankle fractures.Methods Forty-two patients with ankle joint dysfunction after ankle fracture surgery were selected and randomly divided into a treatment group and a control group,with 21 patients in each group.The control group received routine comprehensive rehabilitation therapy(traditional Chinese massage techniques,functional electrical stimulation,ultrasound,interference electricity,traditional Chinese medicine fumigation treatment,and inclined plate standing),and the treatment group received Kaltenborn joint loosening surgery on this basis.Two groups of patients were treated 5 days a week for 10 consecutive weeks.Before and 10 weeks after treatment,the active ankle range of motion and the American Association of Foot and Ankle Surgeons(AOFAS)ankle posterior foot scale scores were evaluated and analyzed by the same therapist.Results There was no significant difference in general information,active ankle range of motion,and ankle AOFAS score between two groups of patients before treatment(P>0.05).After treatment,the ankle joint extension angle of patients in the treatment group and control group was significantly improved compared to patients before treatment(P<0.05),and the treatment group was better than the control group(P<0.05).The plantar flexion angle of two groups of patients was significantly improved compared to patients before treatment(P<0.05),and there was no significant difference between the groups(P>0.05);The AOFAS scores of two groups of patients were significantly improved compared to patients before treatment(P<0.05),and the treatment group was better than the control group(P<0.05).Conclusion:Kaltenborn joint mobilization can significantly improve ankle joint dysfunction after ankle fracture surgery.

关 键 词：Kaltenborn关节松动术 踝关节 功能障碍 康复 

分 类 号：R687.3[医药卫生—骨科学]