中药熏洗结合CPM机在断指再植术后康复中的应用

断指再植术后，患指需要一定时间的制动，虽然手外科医师一再强调手术的无创操作和术后的功能康复，但仍有部分患者出现不同程度的关节僵硬。2001年6月-2005年5月，我科对124例近节手指离断再植术后关节僵硬的患者，应用中药熏洗，结合应用6000X手指CPM机（加拿大生产）进行手功能康复训练，取得了较满意的疗效。     

人工髋关节置换术后肢体康复护理23例

人工髋关节置换术是用人造髋关节代替已无法正常使用的病损髋火节,解决畸形、疼痛和功能障碍,恢复和改善髋关节运动的手术.但由于髋关节术后的康复未引起足够的重视,影响r治疗效果,往往不能达到术前期待的疗效.有学者认为,髋关节置换术后早期的康复训练足保证和巩固手术效果,促进功能康复的重要方法.     

全髋关节置换术患者术后功能锻炼指导单的设计与应用

对全髋关节置换术的患者提供术后功能锻炼的知识及指导,自行设计全髋关节置换术后功能锻炼指导单,将有关知识呈现于表格中,从患者术后1～3 d至术后3个月,对每阶段的功能锻炼予具体指导,并用SF-36评分表及Hariss评分表对患者进行评分。经临床应用结果表明,该指导单能系统、直观地帮助患者早日恢复肢体功能锻炼,提高患者自护水平和生活质量。     

膝部骨折术后CPM机治疗的护理

膝关节僵硬是膝部骨折术后最常见的并发症，常严重影响膝关节功能。由于骨折及手术造成疼痛，病人多不愿主动作关节功能锻炼，极易造成关节僵硬。下肢CPM应用于膝部骨折手术病人后，这一局面大有改观。本院１９９７年７月至２００１年１２月，对９７例膝部骨折术后病人进行CPM机治疗，现将护理体会报告如下。临床资料１．一般资料：本组９７例，男５５例，女４２例；年龄１６～７６岁，平均４６岁。住院时间１０～２１天。股骨髁上骨折２３例，股骨髁间骨折２１例，髌骨严重粉碎骨折１７例，胫骨平台粉碎骨折３４例，浮膝损伤２例。手术…     

PDCA循环在髋关节置换术后患者功能锻炼中的应用

目的探讨PDCA循环在髋关节置换患者术后功能锻炼中的应用效果。方法将髋关节置换患者160例按住院时间顺序分为对照组80例(2013年1~6月)和观察组80例(7~12月),对照组术后按照常规进行功能锻炼,观察组应用PDCA循环通过计划、实施、检查、处理四个阶段进行功能锻炼指导。结果术后2周两组功能锻炼方法掌握正确率比较,差异有统计学意义(均P0.01)。实施3个月后两组髋关节功能恢复情况比较,差异有统计学意义(均P0.01)。结论 PDCA循环应用于髋关节置换患者术后功能锻炼,能显著提高患者的功能锻炼相关知识,进而提高康复护理效果。     

应用椎间盘镜术后康复护理体会

本组195例，男性132例，女性63例，年龄19～78岁，平均41．5岁，病史最短3个月，最长4年，平均16个月，术前：184例行牵引、针灸、理疗及推拿按摩等保守治疗后无效，反复发作；18例推拿按摩后症状加重；1例推拿后出现急性卡压(腰痛伴下肢麻木)。     

全髋关节置换术后翻修术患者的护理

通过对10例全髋关节翻修术患者的护理，指出术前有针对性的心理疏导，术后严密观察病情、预防感染及假体关节脱位、指导功能锻炼是护理的关键。     

先天性髋关节脱位手术后患儿的康复护理

我院 1 993年 7月至 2 0 0 0年 6月共收治先天性髋关节脱位患儿 3 8例 ,手术治疗后加强康复锻炼 ,效果满意。现将康复护理总结如下。1　临床资料3 8例中 ,男 1 1例、女 2 7例 ,年龄 2 .5～ 1 1岁 ,平均 5 .5岁。左侧脱位 1 6例 ,右侧 1 0例 ,双侧 1 2例。术前均因下肢不等长 ,行走呈跛行步态 ,经临床确诊先天性髋关节脱位入院。本组患儿入院后先予患肢骨骼牵引 3周后行改良沙氏手术治疗复位 ,术后早期行髋关节功能锻炼。2　方法2 .1　手术方法本组患儿在全麻下行内收肌松解、切开复位 +改良的 Salter骨盆截骨术 ,术后髋人字石膏外固定3～ 6…     

人工全髋关节置换术的术后护理

人工全髋关节置换是治疗老年人骰骨颈骨折和股骨头缺血性坏死等髋关节疾患的重要方法。而人工全髋义节术后康复护理和功能锻炼,对病人术后功能恢复至关重要,不仅可以帮助患者及时恢复关节功能,提高于术的疗效和生活质量,而且可以减少和预防各种并发症的发生。我科自2005年6月至2009年12月以来,对235例人工全髋关节置换术患者,施行整体护理,取得满意的效果。现将护理体会报告如下。     

程序化功能锻炼在全髋关节置换患者中的应用体会

<正>人工全髋关节置换是解除全髋关节疾病患者病痛、纠正畸形、恢复功能的有效方法。术后功能训练是预防发生并发症、保证手术效果的重要环节。2011-01—2013-01,我们对59例全髋关节置换患者应用程序化功能锻炼,效果满意,现报道如下。     

特殊类型全髋关节置换术的疗效分析

目的探讨成人髋臼发育不良致股骨头坏死和股骨上端骨肿瘤患者行全髋关节置换术的疗效。方法对10例16侧成人髋臼发育不良并股骨头坏死者(双侧6例,单侧4例)行全髋关节置换术,另对8例股骨近端肿瘤者(3例复发性骨巨细胞瘤,5例骨转移瘤)作瘤段切除全髋关节置换术。结果术后所有患者均获随访。股骨头坏死16侧Harris评分由术前的平均36.6分恢复到术后的89分;8例股骨近端肿瘤经假体置换后,Harris评分平均为93.5分。结论全髋关节置换术治疗成人髋臼发育不良致股骨头坏死及股骨近端肿瘤疗效确切,用以治疗股骨近端肿瘤具有肿瘤切除彻底、负重早、功能恢复快及生活质量高的优点。     

The Use of Combined Anteversion in Total Hip Arthroplasty for Patients With Developmental Dysplasia of the Hip

The combined anteversion technique has been proposed recently and proved to be an applicable technique in general THA. The corresponding author routinely applied this approach to DDH patients in clinical practice. The current study aimed to provide clinical evidence for this approach. We studied 35 DDH patients (47 hips). Every patient underwent pelvic CT scans before and after surgery and the HHs was recorded. The data indicate a high accuracy of controlling components orientation and satisfactory clinical outcomes. Using this approach, we reduced dislocation risk and got better impingement free range of motion. Therefore, we conclude that combined anteversion is effective for DDH patients who receive a THA. This approach could guarantee stable and functioning joints for DDH patients receiving THA.     

Hip Arthroscopy: The Use of Computer Assistance

Background:

Hip arthroscopy is rapidly becoming the mainstay of treatment for femoroacetabular impingement (FAI), but remains technically demanding and has its limitations. The failures of arthroscopic FAI surgery due to inaccurate and inadequate resection are reported to be increasing. Computer-assisted surgery (CAS) can theoretically improve the accuracy and precision of the osseous resections required to treat FAI. It does so by providing a preoperative assessment tool, an intraoperative tracking device, and a robotic-assisted cutting instrument.

Questions/Purposes:

The purpose of this review is to discuss the evolution of CAS to address the current limitations of arthroscopic FAI surgery and propose the features required of the ideal CAS solution for FAI.

Methods:

A computerized keyword search of MEDLINE was performed for studies that investigated the use of computer assistance in FAI surgery. Data was collected on preoperative assessment tools, intraoperative navigation programs, and robotic-assisted execution of FAI surgery.

Results:

Sixty-one articles were identified after the keyword search. Nineteen studies met our inclusion criteria. Thirteen studies were selected to address our study questions: three studies were analyzed for preoperative planning, six for navigated osseous resection, and four for robotic-assisted execution.

Conclusion:

Navigation and robotic-assisted surgery can preoperatively plan and execute osseous resection with greater accuracy compared to freehand techniques, although the clinical success and cost-effectiveness has yet to be demonstrated. The ideal CAS solution must be able to virtually plan a resection, guide the surgeon towards accurate execution of the plan, and facilitate post-resection assessment of the adequacy of resection.     

全髋关节置换术患者的康复护理

目的探讨人工全髋关节置换术前后早期进行科学功能康复训练的效果。方法制定一整套人工全髋关节置换术围手术期功能康复训练程序，掌握训练进度，采取尽早开始、循序渐进、个别对待、随时调整、持之以恒的原则。结果本组68例全髋关节置换术．髋关节功能按Charnley标准评分，疗效判定优31例，良18例，可15例，差4例，优良率72％。结论功能康复训练程序具有康复快、关节功能恢复效果好、并发症少的特点。     

肱骨髁间骨折Y型钢板内固定术后康复指导

对19例肱骨髁间骨折病人行Y型钢板内固定术后早期应用肘关节功能康复器(CPM)功能锻炼,指导病人在不同时期的锻炼方法,并与主动训练相结合.结果13个月后随访,肢体功能评定优14例,良4例,一般1例(陈旧性骨折并有肘关节周围广泛性瘢痕增生),提示采用Y形钢板内固定结合CPM功能锻炼治疗肱骨髁间骨折具有固定牢靠、肘关节功能恢复满意的优点.     

Use of a New High-Activity Arthroplasty Score to Assess Function of Young Patients With Total Hip or Knee Arthroplasty

The High-Activity Arthroplasty Score (HAAS) was specifically developed to assess subtle variations in functional ability after lower limb arthroplasty with particular regard to highly functioning individuals. The score was a 4-item self-assessment measure covering the 4 domains of walking, running, stair climbing, and general activities, with a possible score ranging from 0 to 18 points. The score was validated in 22 patients (total hip arthroplasty [THA], n = 11; total knee arthroplasty [TKA], n = 11) by comparison with the Oxford, Knee Society, Harris Hip, and Short WOMAC scores. The HAAS was then administered to 152 high-functioning arthroplasty patients (THA, n = 99; TKA, n = 53), all younger than 66 years. The HAAS produced a much wider range of scores, allowing greater differentiation of level of function between patients in assessing performance after TKA or THA.     

老年髋部骨折术后患者康复需求程度与康复状况调查

目的 了解老年髋部骨折术后患者康复需求程度、需求满足度与康复状况的关系。方法 上门随访82例老年髋部骨折术后患者家庭康复现状和康复需求情况。结果 康复需求10个维度中他人支持、康复信息及功能训练指导位居前3位；需求程度与生理功能、躯体功能和社会功能有关（P〈0．05，P〈0．01）；与髋关节功能评分中的疼痛程度、上楼梯、穿鞋袜和行走距离4个方面有关（P〈0．05，P〈0．01）。结论 出院后定期给予针对性的康复训练指导和健康教育是患者迫切的需求；康复需求程度高者，相应需求满足率低，其生活质量及髋关节功能恢复应成为干预的重点。