肘关节创伤术后围手术期系统康复的临床研究  

Clinical study on early postoperative rehabilitation following intra-articular fractures of the elbow

作　　者：闫汝蕴[1] 覃鼎文[1] 陆琳[1] 

机构地区：[1]北京积水潭医院物理医学康复科

出　　处：《中国康复医学杂志》2003年第11期673-675,共3页Chinese Journal of Rehabilitation Medicine

摘　　要：目的:前瞻性地研究严重肘关节创伤患者,术后围手术期系统康复治疗。方法:选择2002年8月—2003年5月间在我院创伤骨科住院治疗的肘关节创伤患者26例为研究对象,所有入选病例均为肘部关节内骨折的患者;并于伤后7—10天实施骨折切开复位内固定手术治疗。术后第1—5天开始康复治疗;随机选择对照组30例(术后自行锻炼)。结果:治疗组患者术后康复治疗时间为4—16周、平均(8.2±4.6)周;治疗结束时患者肘关节活动范围均达到正常,Mayo肘关节评分,20例为优(总分≥90分),6例为良(总分80—89分),优良率为100%。GEPI评分:2%—10%、平均5.9%±1.9%;无一例出现内固定物松动、骨折不愈合、废用性骨质疏松的征象。结论:肘关节严重创伤术后实行围手术期、个性化、系统性康复治疗,能够促进骨折愈合、伤肢功能障碍降低到最低的程度,从而提高了严重创伤患者的生活质量,康复治疗是骨关节损伤治疗过程中必不可少的重要环节。Objective:To study the effect of early postoperative rehabilitation following intra-articular fractures of the elbow with tailored procedure.Method:26patients,intra-articular fractures of elbow,were admitted and operated in the hospital from Aug2002to May2003.The rehabilitation process usually begun at24hour postoperatively.Passive,active-assisted and active ROM exercises of elbow,daily strengthening and anti-resistance exercises were performed in different periods.Randomly selected other30patients,the injure situations matched,were as contrast,postoperatively exercises by themselves.Result:The overall length of rehabilitation was8.2±4.6weeks.Compared with the contrast,general motion and Mayo score of elbow were tremendous different.At the end of rehabilitation,Mayo score of20of the26patients were excellent,6were good.According to GEPI score of elbow treated patients was2%-10%,mean5.9%±1.9%,contrast13.9%±3.1%.No complications were observed,osteoporosis,heterotopic ossification,malunion and nonunion,etc.Conclusion:Early rehabilitation could facilitate restoration function and range of motion for the patients with intra-articular fractures of the elbow.The rehabilitation protocol must be modified according to the patient's condition and the state of the tissues observed during surgery.

关 键 词：肘关节创伤 术后 围手术期 系统康复 临床研究 切开复位内固定术 

分 类 号：R49[医药卫生—康复医学]