纸夹板外固定治疗踝关节骨折后期功能康复介入时间与疗效关系初探

目的:探索功能锻炼介入时间对踝关节骨折后期功能恢复的影响。方法:本组120例踝关节骨折,男62例,女58例;年龄18~69岁,平均46.54岁。受伤肢体左侧49例,右侧71例。随机分为A、B、C、D 4组,每组各30例,均行手法复位纸夹板外固定治疗,对复位满意者按A、B、C、D分组分别于3、4、5、6周开始介入手法康复治疗。全部患者均于骨折后8周、10周、12周接受随访,通过Takakura踝关节评分系统进行功能评价。结果:4组120例患者,功能锻炼介入及不同时间的疗效评价观察,B组(4周)康复介入后,功能恢复的效果及评分最优,观察时间在8、10、12周时,评分分别是(54.37±4.50)分、(74.53±4.31)分、(92.07±3.81)分,P0.01。结论:踝关节骨折后功能锻炼的介入时间最好在4周左右,此时既不会造成骨折重新移位,又不会造成踝关节功能恢复时间延长,过早或过晚都不利踝关节的功能恢复。

Exploration on Relations between Intervention Time and Therapeutic Effect of Paper Splint External Fixation in Treating Ankle Fractures

Objective：To explore the effects of exercise intervention time on functional recovery of ankle joint fracture.Methods：One hundred and twenty cases of ankle fracture patients were included in the study,among which 62 were male and 58 were female,aged from 18 to 69 years,average 46.54 years old.There were 49 cases injured in left limbs and 71cases in the right limbs.Patients were randomly divided into Group A,B,C,and D,with 30 cases in each.Patients were all treated with manual reduction and paper splint external fixation,and those who gained satisfactory therapeutic effects were given manipulations for rehabilitation intervention accordingly in orders of group A,B,C,D started respectively on the 3rd,4th,5th,and 6th week.All of the patients got follow-ups 8 weeks,10 weeks,and 12 weeks after the fracture with Takakura,a scoring system to evaluate ankle joint functional.Results：Patients in group B who received rehabilitation intervention on the 4th week showed the best recovery effect and scores,and the score observed on the 8th, 10th,and 12th week were respectively （54.37 ±4.50）min,（74.53 ±4.31）min,（92.07 ±3.81）min,P〈0.01.Conclusion：The best exercise intervention time after fracture of ankle joint is in about 4 weeks,when neither the fracture would be relocated,nor the functional recovery time of the ankle joint would be extended.