膝关节韧带损伤早期应用膝矫形器与动态石膏固定对膝关节功能恢复的影响

Effects of function improvement in acute knee-joint ligament injury between knee orthosis and dynamic action plaster immobilization

目的 :探讨膝韧带损伤急性期康复治疗中配置加锁膝关节绞链矫形器与动态石膏固定对膝关节功能恢复的不同影响。方法 :两组伤后即分别配置矫形器与动态石膏固定 4周 ,固定期间及拆除固定后进行康复治疗 ,3月后进行功能评估比较疗效。结果 :矫形器组与动态石膏组膝关节主动ROM与被动ROM差异在统计学上有显著性(t值分别为 4.5 9及 3 .2 3,P分别 <0 .0 0 1及 <0 .0 1) ,膝关节功能Lysholmp评分差异在统计学上亦有显著性 (t值为 2 .93,P <0 .0 1)。结论 :动态石膏固定在一定程度上可预防关节挛缩 ,但肌无力及关节不稳不能解除。加锁膝关节绞链矫形器配置有利于膝关节在保护范围内进行功能训练 ,有效地解决了制动与功能训练之间的矛盾 。

Objective: To explore the different effect to function improvement of acute knee-joint ligament injure after rehabilitation therapy with hinge-locked knee orthosis or dynamic action plaster immobilization. Method: Orthosis or dynamic action plaster immobilization were used 4 weeks after acute injure in two groups. Rehabilitation therapy were arranged during immobilization and free periods, Function assessment comparison were conducted 3 months later.Result:ROM active and ROM passive were significantly different between the two groups( P<0.001, P <0.01). The Lysholmp scorings of the two groups were also significantly different ( P <0.01). Conclusion: Dynamic action plaster immobilization could gently prevent contraction, but could not obviously improve muscle weakness and instability of the joint. Hinge-locked keen orthosis provided not only safe training within protective ROM. Stable immobilization could obviously improve ROM and function of the knee-joint. Author′s address\ Dept. of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University of Medical Sciences, Guangzhou, 510080