压力保护支具在老年股骨粗隆间骨折术后康复训练中的应用

目的 观察带有压力传感保护装置(自主研发)的康复训练支具在骨折早期进行康复训练对骨折愈合的效果.方法 选取40例资料完整、符合条件的老年股骨粗隆间骨折行动力髋螺钉内固定术后患者,随机分为实验组和对照组各20例.实验组患者应用带压力传感器保护装置(自2008年5月开始研制带有压力传感保护装置的康复训练支具,2009年1月至2010年6月临床推广应用)的下肢康复训练支具,在术后不同时期,根据患者具体情况,由医师通过计算机调控支具应力阈值,按照预定的个性化康复计划,指导患者借助双拐进行负重行走康复训练.对照组采用传统的康复治疗方法.按照统一的标准评价骨折临床愈合和骨性愈合时间.结果 随访13.0～24.0周,平均17.6周.实验组临床愈合时间7.0～12.0周,平均9.1周;骨性愈合时间12.0～16.0周,平均13.7周.对照组临床愈合时间9.0～13.0周,平均11.3周;骨性愈合时间14.0～20.0周,平均16.6周.2组间骨折临床愈合时间和骨性愈合时间经独立样本t检验,结果显示2组间骨折临床愈合时间和骨性愈合时间差异均有统计学意义(t值分别为5.174、5.846,P均＜0.01).最终2组骨折均愈合,无骨折移位,无内固定物折断、松脱、失效等不良并发症.结论 应用带有压力传感保护装置的康复训练支具,在骨折早期由医师根据患者体重调控间断纵向应力刺激阈值,指导患者进行有效的量化的个性化康复训练,可以达到促进骨折愈合、缩短疗程、减少并发症目的.进一步证明在一定范围内间断的压应力刺激对骨折愈合有促进作用.

Abstract：

Objective To observe the effect of pressure-protective brace with pressure-sensitive device in the early stage rehabilitation training enhance bone healing, shorten the treatment course and reduce complications,a kind of independently developed pressure-protective brace with pressure-sensitive device was utilized with quantified discontinuous longitudinal stress stimulation under doctors' regulation according to procedure. Methods The pressure-protective brace with pressure sensitive device for rehabilitation training was developed in May 2008 ,and was applied in clinics during January 2009 to June 2010. Forty elder patients,with complete clinical data, underwent Dynamic Hip Screw (DHS) internal fixation of femoral intertrochanteric fracture were were enrolled into this study. These cases were assigned into experimental group and control group with 20 patients respectively. The patients of experimental group performed lower extremity rehabilitation training wearing the pressure-protective brace. The load training of lower extremities with double crutches was modulated by doctors through regulating the threshold value of pressure in different time and different condition after operation according to the prearranged rehabilitative plan of individuation. The controls were instructed to performed lower extremity rehabilitation training in traditional way. Both the clinical healing and bone union time in all cases were evaluated according to the uniform standard. Results Total 40 patients were followed up for 13.0 - 24. 0 weeks ( average, 17.6 weeks ). Clinical healing time was 7.0 - 12. 0 weeks ( average,9. 1 weeks ) and bone healing time was 12. 0 - 16.0 weeks(average,13. 7 weeks)in experimental group. While in control group,the clinic healing time and bone union time was 9. 0 - 13.0 weeks( average, 11.3 weeks) and 14. 0 -20. 0 weeks (average, 16. 6 weeks)respectively. The Independent T-test results showed that whether clinic healing time or bone healing time presented significant differences between experimental group and the controls( P＜0. 01 ). All of the fractures in these two groups were healed at the end time of follow up without adverse complications,including fracture displacement, implant break, implant loose and failure. Conclusion The pressure-protective brace with pressure sensitive device used for quantifying rehabilitation training can enhance bone union, shorten the treatment course and reduce complications. This method further proves that discontinuous compressive stress in a certain range can stimulate fracture healing.

Application of pressure-protective brace in the rehabilitation training for the elder patients after surgical operation of femoral intertrochanteric fracture

Objective To observe the effect of pressure-protective brace with pressure-sensitive device in the early stage rehabilitation training enhance bone healing, shorten the treatment course and reduce complications,a kind of independently developed pressure-protective brace with pressure-sensitive device was utilized with quantified discontinuous longitudinal stress stimulation under doctors' regulation according to procedure. Methods The pressure-protective brace with pressure sensitive device for rehabilitation training was developed in May 2008 ,and was applied in clinics during January 2009 to June 2010. Forty elder patients,with complete clinical data, underwent Dynamic Hip Screw (DHS) internal fixation of femoral intertrochanteric fracture were were enrolled into this study. These cases were assigned into experimental group and control group with 20 patients respectively. The patients of experimental group performed lower extremity rehabilitation training wearing the pressure-protective brace. The load training of lower extremities with double crutches was modulated by doctors through regulating the threshold value of pressure in different time and different condition after operation according to the prearranged rehabilitative plan of individuation. The controls were instructed to performed lower extremity rehabilitation training in traditional way. Both the clinical healing and bone union time in all cases were evaluated according to the uniform standard. Results Total 40 patients were followed up for 13.0 - 24. 0 weeks ( average, 17.6 weeks ). Clinical healing time was 7.0 - 12. 0 weeks ( average,9. 1 weeks ) and bone healing time was 12. 0 - 16.0 weeks(average,13. 7 weeks)in experimental group. While in control group,the clinic healing time and bone union time was 9. 0 - 13.0 weeks( average, 11.3 weeks) and 14. 0 -20. 0 weeks (average, 16. 6 weeks)respectively. The Independent T-test results showed that whether clinic healing time or bone healing time presented significant differences between experimental group and the controls( P＜0. 01 ). All of the fractures in these two groups were healed at the end time of follow up without adverse complications,including fracture displacement, implant break, implant loose and failure. Conclusion The pressure-protective brace with pressure sensitive device used for quantifying rehabilitation training can enhance bone union, shorten the treatment course and reduce complications. This method further proves that discontinuous compressive stress in a certain range can stimulate fracture healing.