膝关节周围骨折术后早期运动康复的临床疗效观察
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【摘要】 目的 膝关节周围骨折切开复位内固定术后早期运动康复与传统治疗的疗效比较。方法 对本院自2006年1月～2009年1月176例膝关节周围骨折病例，随机分为早期康复治疗组和传统治疗对照组：每组各有股骨髁上和/或髁部骨折38例和34例；胫骨平台骨折45例和37例；髌骨骨折12例和10例。术后六个月随访并对患者行Lysholm膝关节评分和膝关节活动范围(Range of motion，ROM)测量。结果 两组患者Lysholm膝关节评分和膝关节活动范围（ROM）有差异有显著性意(P
【关键词】膝关节周围骨折; 康复训练
Clinical curative effect observation of early exercise rehabilitation on the postoperative with fractures around the knee
Cao shengsheng,Luo tong,Qing yuhong,Xu wenhua,Li junning,Li gang,Fu yu
Department of orthopedics,Yichun people’s hospital,Yichun,336000,China
Abstract：Objective To compare the effect between the early exercise and rehabilitation and conventional treatments by open reduction and internal fixation after fractures around the knee. Methods 176 patients with fractures around the knee were enrolled from our hospital from January 2006 to January 2009,which were allocated randomizedly to the early rehabilitation group and the conventional treatments group. In each group, the cases of supracondylar fracture of femur and (or) condylar fracture, tibia plateau fractures and patella fracture were 38 and 34, 45and 37, 12 and 10 respectively. The knee joint score and range of motion were measured in the end of six months after the surgery. Results There were significant differences in Lysholm knee joint score and range of motion between two groups(P
Key words：fractures around the knee；rehabilitation training
膝关节周围骨折包括股骨髁上和髁部骨折、髌骨骨折、胫骨平台骨折。膝关节功能障碍是其术后常见的并发症，治疗中将“复位、固定、功能锻炼”三大原则认为是治疗的三个孤立的阶段而忽略了“动静结合”是导致其发生的主要原因。我科自2006年1月～2009年1月对膝关节周围骨折术后采用早期系统康复训练治疗，获得了与传统康复治疗(即：恢复期开始功能锻炼)相比更为满意的功能恢复。
1 资料与方法
1.1 临床资料
选择2006年1月～2009年1月在我科行手术治疗的膝关节周围骨折患者共176 例, 随机分为早期康复治疗组和传统治疗对照组，进行对比研究。治疗组股骨髁上和/或髁部骨折38例,男28例,女10例, 年龄16～58(35.3±6.2)岁；胫骨上段骨折45例,男31例,女14例,年龄24～61(31.9±7.0)岁；髌骨骨折12例,男7例,女5例,年龄29～64(39±9.4)岁。对照组股骨髁上和/或髁部骨折34例,男26例,女8例,年龄18～58(36.3±5.6)岁；胫骨上段骨折37例,男26例,女11例,年龄24～59(31.9±6.0)岁；髌骨骨折10例,男5例,女5例,年龄25～63(36±8.8)岁。所有病例均为单一闭合或开放骨折,无合并血管、神经、肌腱韧带损伤，也不伴发其他内科疾病。骨折AO分型情况见表1。