髌骨骨折髌骨爪内固定术后康复治疗的随机对照研究

髌骨骨折占全身骨折损伤的1.05%,大部分由直接及间接暴力联合所致1]。髌骨骨折可造成伸膝结构的连续性丧失及潜在的髌股关节失配,如髌骨关节面不平整程度超过1mm,发生创伤性关节炎的概率就会增加约20%2]。因此,临床治疗髌骨骨折的目标为重建伸膝结构连续性,恢复髌骨关节面平整,进行有效的内固定并开始早期康复治疗3]。采用可分离式髌骨爪内固定可取得比传统改良张力带具有更好的早期恢复效果4],患者术后康复训练的依从性相对

The effectiveness of distinctive rehabilitation interventions following internal fixation with patellar concentrator in patients following patellar fracture: a randomized control study

Objective: To compare the effectiveness of acute rehabilitation intervention and traditional therapy on the patients with internal fixation following patellar fracture and provide evidence for optimal therapeutic exercise options. Methods: 86 subjects who admitted for internal fixation by detachable patellar concentrator between Jan/2010 and Sep/2013 and divided randomly into two groups: Acute Group (n=43) and Traditional Group (n=43). Two distinctive programs of post-operative intervention were implemented respectively and the functionality of knee joint was evaluated with HSS, range of motion (ROM) and the muscle atrophy of quadriceps femoris. Results: HSS scores were 92.9±12.2 and 77.2±10.1 for acute and traditional group respectively (P<0.05) and the percentage of patients with optimal outcome was 110% and 90.7% respectively (P<0.05). The number of patients with ROM greater than >120° and >90° in Acute group was 35 and 7, while there were 15 and 24 respectively in the Traditional group (P<0.01). The differences of circumference of thigh at surgery and 3 months after surgery were evaluated and numbers of the subjects with a difference of 25mm were 2 and 16 (P<0.05). Conclusion: Early intervention with comprehensive rehabilitation exercise was valuable to improve the outcome following internal fixation with detachable patellar concentrator for patients suffering patellar fracture.