膝关节周围骨折术后的康复护理

Postoperative fractures around the knee rehabilitation nursing.

目的回顾性分析膝关节周围骨折的治疗方法和效果。方法膝关节周围骨折损伤的患者先修复血管后固定骨折7例，先固定骨折再修复血管6例，在处理骨折前先建立临时性动脉内分流8例。结果所有患者均获随访，随访时间1～7年，平均3．3年。肢体存活17例（81％），截肢4例。截肢者均为入院时肢体严重缺血患者，部分缺血患者无截肢；截肢患者中有3例合并严重软组织损伤，1例合并中度软组织损伤；肢体存活患者平均MESS评分（4．2±1．3）分，截肢患者平均（7．2±1．8）分。截肢患者均是由于术后出现难以控制的感染而截肢。结论因未能早期合理的功能锻炼，常导致肢体功能受限或需二次手术关节松解治疗，应对膝关节周围骨折的术后疗效及康复护理做好安排。

Objective Retrospective analysis of treatment of fractures around the knee and the effects of. Methods In patients with fractures around the knee injury in the first repair blood vessels, seven cases of fracture after fixation, first fixation fracture repair blood vessels and then in 6 cases,in dealing with fractures prior to the establishment of a temporary arterial shunt in 8 cases. Results All patients were followed up for 1 to 7 years,an average of 3.3 years. Limb survival in 17 patients（81% ） ,amputation in 4 cases. Limb amputees are at admission in patients with severe ischemia, some of ischemia in patients with non - one cases of amputation ; amputation,there are three cases of patients with severe soft tissue injury, 1 case combined with moderate soft tissue injury;limb survival in patients with mean MESS score （4. 2 ± 1.3 ）, amputation in patients with an average of （7.2 ± 1.8 ）. Amputation patients are difficult to control because of postoperative infection occurred amputation. Conclusion Early function of failing to exercise reasonable, often leads to limb function, or be subject to joint loosening secondary surgical treatment of fractures around the knee surgery should efficacy and rehabilitative care to make arrangements.