早期足底应力刺激对跟骨骨折术后康复的影响

Effect of Early Plantar Stress Stimulation on Postoperative Rehabilitation of Calcaneal Fracture

目的 研究分析早期足底应力刺激对跟骨骨折切开复位内固定术后康复的影响。方法 随机选取2020年1月—2021年8月于厦门大学附属福州第二医院创伤骨科接受切开复位内固定术的90例跟骨骨折患者,按术后康复方法不同分为观察组(45例)和对照组(45例),观察组采用自研的足底应力刺激康复器行康复训练,对照组按传统术后康复措施予以关节被动锻炼。比较两组的术后消肿时间、骨折愈合时间和切口并发症发生情况,采用美国足与踝关节协会(AOFAS)评分系统评价踝关节功能。结果 观察组术后消肿时间、术后3个月AOFAS评分、术后6个月AOFAS评分分别为(3.84±1.24)d、(90.62±5.19)分、(93.91±4.94)分,均优于对照组的术后消肿时间(5.13±1.59)d、术后3个月AOFAS评分(81.96±7.44)分、术后6个月AOFAS评分(91.38±5.19)分,差异有统计学意义(t=4.292、6.404、2.369,P<0.05)。结论 早期足底应力刺激在跟骨骨折切开复位内固定术后的康复过程中有利于更快消肿,更早恢复患肢功能,不影响骨折愈合,不增加术后切口并发症,更有助于跟骨骨折患者的术后康复。

Objective To study the effect of early plantar stress stimulation on postoperative rehabilitation of calcaneal fracture after open reduction and internal fixation.Methods 90 patients with calcaneal fractures who underwent open reduction and internal fixation surgery at the Department of Trauma and Orthopedics,Fuzhou Second Hospital,Xia⁃men University from January 2020 to August 2021 were selected randomly and divided into an observation group(45 cases)and a control group(45 cases)according to different postoperative rehabilitation methods.The observation group received rehabilitation training using a self-developed plantar stress stimulation rehabilitation device,while the control group received passive joint exercise according to traditional postoperative rehabilitation measures.Compared the postoperative swelling reduction time,fracture healing time,and incision complications between the two groups,and evaluated ankle joint function using the American Association of Orthopedic Foot and Ankle Surgeons(AOFAS)scoring system.Results The observation group's postoperative swelling reduction time,3-month AOFAS score,and 6-month AOFAS score were(3.84±1.24)days,(90.62±5.19)points,and(93.91±4.94)points,respectively,which were better than the control group's postoperative swelling reduction time(5.13±1.59)days,3-month AOFAS score(81.96±7.44)points,and 6-month AOFAS score(91.38±5.19)points,respectively,and the difference was statistically signifi⁃cant(t=4.292,6.404,2.369,P<0.05).Conclusion Early plantar stress stimulation in the rehabilitation process after open reduction and internal fixation of calcaneal fractures is beneficial for faster swelling reduction,earlier recovery of affected limb function, no impact on fracture healing, no increase in postoperative incision complications, and moreconducive to postoperative rehabilitation of patients with calcaneal fractures.