改良张力支具对肱骨髁间骨折患者术后功能康复的临床效果评价

Clinical evaluation of functional rehabilitation of patients with humeral intercondylar fractures and modified tension brace

目的探讨改良张力支具对肱骨髁间骨折患者术后功能康复的临床效果评价。方法回顾性分析本院采用切开复位内固定术治疗的40例肱骨髁间骨折患者的资料。单纯采用普通固定支具进行功能锻炼的为对照组(21例),采用改良张力支具进行功能锻炼的为观察组(19例)。比较两组患者术后去除支具和末次随访时肘关节屈曲度、肘关节背伸度、前臂旋前度、前臂旋后度和Mayo肘关节功能评分,以评定改良张力支具的疗效。结果所有患者术后均获得随访,平均随访13.79个月。观察组与对照组相比,术后去除支具时肘关节屈伸活动度[(104.47±12.37)°vs.(88.85±8.10)°,P<0.001],差异有统计学意义;肘关节旋转活动度[(140.31±16.87)°vs.(135.66±12.86)°,P=0.331],差异无统计学意义;肘关节Mayo评分[(78.84±5.04)分vs.(73.80±4.46)分,P=0.002],差异有统计学意义。末次随访时肘关节屈伸活动度[(107.52±12.30)°vs.(93.00±8.47)°,P<0.001],差异有统计学意义;肘关节旋转活动度[(141.42±17.02)°vs.(137.19±12.80)°,P=0.37],差异无统计学意义;肘关节Mayo评分[(80.15±5.24)分vs.(74.95±4.18)分,P=0.001],差异有统计学意义。结论术后使用改良张力支具可以改善肱骨髁间骨折患者的屈伸活动度和肘关节功能。

Background At present,the adjustable brace can meet the needs of the elbow joint auxiliary stabilization and early functional exercise after the intercondylar fracture of the humerus.However,the adjustable brace still has certain disadvantages,so our hospital has improved the adjustable elbow brace,developed a relatively small tension,more flexible adjustment of the tension braces,and applied it to the postoperative rehabilitation exercises of clinical intercondylar fracture patients.Objective To investigate the clinical effect of modified tension braces on postoperative functional rehabilitation in patients with intercondylar humerus fractures.Methods The data of 40 patients with intercondylar fractures of the humerus treated by incision reduction and internal fixation were retrospectively analyzed.The control group(21 cases)used ordinary fixed braces for functional exercises alone,and the observation group(19 cases)used modified tension braces for practical exercises.The elbow flexion,dorsal elbow elongation,forearm rotation,forearm rotation,and Mayo elbow function score at postoperative brace removal and final follow-up were compared between the two groups to assess the efficacy of improving tension braces.Results All patients were followed up after surgery,with an average follow-up of 13.79 months.Compared with the control group,the ranges of motion of the elbow joint were[(104.47±12.37)°vs.(88.85±8.10)°,P<0.001]when removing the brace after surgery was observed.The ranges of motion of the elbow joint were[(140.31±16.87)°vs.(135.66±12.86)°,P=0.331],and the difference was not statistically significant.The mayo scores of the elbow joint[(78.84±5.04)points vs.(73.80±4.46)points,P=0.002],and the difference was statistically significant.The ranges of flexion and extension of the elbow at the last follow-up were[(107.52±12.30)°vs.(93.00±8.47)°,P<0.001],and the difference was statistically significant.The elbow rotational ranges of motion were[(141.42±17.02)°vs.(137.19±12.80)°,P=0.37],and the difference was not statistically significant.The elbow Mayo scores were[(80.15±5.24)points vs.(74.95±4.18)points,P=0.001],and the difference was statistically significant.Conclusions The use of modified tension braces after surgery can improve the flexion range of motion and elbow joint function in patients with intercondylar humerus fractures.