持续被动运动机辅助功能锻炼在胫骨平台骨折术后的应用

Application of continuous passive motion machine assisted functional exercise after the surgery of tibial plateau fracture

目的探讨持续被动运动(CPM)机辅助功能锻炼在胫骨平台骨折术后的应用。方法选择2017年1月~2019年1月在我院创伤骨科收住的胫骨平台骨折患者92例,采用抛银币法分为CPM组与对照组,每组各46例。两组患者均行胫骨平台骨折切开复位内固定术。对照组术后患肢主动运动训练,CPM组术后第2天开始进行CPM机辅助功能锻炼,两组患者均治疗6个月。观察两组患者治疗后膝关节及胫骨平台后倾角(PA)恢复情况。结果治疗6个月后,两组患者ROM、膝关节Harris评分和BI评分均较治疗前明显上升(P<0.05或P<0.01),且CPM组上升幅度较对照组更高,差异有统计学意义(P<0.05);两组患者PA较治疗前明显上升(P<0.05或P<0.01),且CPM组上升幅度较对照组更更高,差异有统计学意义(P<0.05)。结论CPM机辅助功能锻炼用于胫骨平台骨折术后的疗效确切,能增加患者关节活动度,能有效矫正PA,改善膝关节功能,从而提高患者独立活动能力。

Objective To explore the application of continuous passive motion(CPM)machine assisted functional exercise after the surgery of tibial plateau fracture.Methods A total of 92 patients with tibial plateau fractures who were admitted in the department of Traumatology and Orthopaedics in our hospital from January 2017 to January 2019 were selected.The patients were divided into CPM group and control group by coin flipping method,with 46 patients in each group.Both groups of patients were given open reduction and internal fixation of tibial plateau fracture.In the control group,active motion training of the affected limb was performed.CPM group was given CPM machine assisted functional exercise on the second day after surgery.Patients in both groups were treated for 6 months.The recovery of knee joint and tibial plateau posterior angle(PA)after treatment in both groups of patients was observed.Results After 6 months of treatment,the ROM,knee joint Harris score,and BI score in both groups of patients were significantly higher than those before treatment(P<0.05 or P<0.01),and the increase in the CPM group was more significant than that in the control group(P<0.05);PA in both groups was significantly higher than that before treatment(P<0.05 or P<0.01),and the increase in the CPM group was more significant than that in the control group(P<0.05).Conclusion CPM machine assisted functional exercise is effective in the treatment of postoperative tibial plateau fractures.It can increase the joint mobility of patients,correct PA more effectively,improve knee joint function,and improve patients'independent ability for motion.