术后被动持续运动在踝关节骨折术后康复中的应用效果观察

Observation on the effect of postoperative continuous passive movement in postoperative rehabilitation of ankle fractures

目的 探究在踝关节术后康复中进行被动持续运动的临床效果。方法 52例行踝关节骨折术患者,通过抽签法将其分为对照组和研究组,每组26例。研究组术后给予被动持续运动,对照组术后进行主动活动。比较两组患者出院时的踝关节周径、矢状面活动度、冠状面活动度以及视觉模拟评分法(VAS)评分、美国矫形外科足踝协会量表(AOFAS)评分、术后并发症发生情况。结果 出院时,研究组踝关节周径(22.18±1.67)cm小于对照组的(23.45±1.03)cm,矢状面活动度(50.24±2.06)°、冠状面活动度(47.87±2.69)°均高于对照组的(32.56±3.58)、(38.32±2.71)°,差异均具有统计学意义(P<0.05)。研究组患者初次下地时VAS评分(2.17±0.93)分低于对照组的(3.24±1.07)分,术后半年的AOFAS评分(91.79±5.26)分高于对照组的(85.15±4.88)分,差异均具有统计学意义(P<0.05)。研究组术后并发症发生率为7.69%(2/26),与对照组的3.85%(1/26)比较,差异无统计学意义(χ^(2)=0.354, P>0.05)。所有发生并发症的患者进行抗生素治疗后感染均痊愈。结论 踝关节骨折术后应用被动持续运动可以促进患者踝关节功能改善,减轻初次下地时的疼痛,同时不会增加患者切口感染的风险,可以作为踝关节骨折术后康复训练的一种有效方式推广应用。

Objective To investigate the clinical effect of postoperative continuous passive movement in postoperative rehabilitation of ankle fractures.Methods A total of 52 cases of ankle fracture patients were divided into control group and study group by lottery method,with 26 cases in each group.The study group received postoperative continuous passive movement,while the control group received postoperative active movement.Both groups were compared in terms of ankle circumference,sagittal range of motion,coronal range of motion at discharge,visual analogue scale(VAS)score,American Orthopaedic Foot and Ankle Society(AOFAS)score and postoperative complications.Results At discharge,the ankle circumference of(22.18±1.67)cm in the research group was smaller than that of(23.45±1.03)cm in the control group;sagittal plane motion of(50.24±2.06)°and coronal range of motion of(47.87±2.69)°in the research group were higher than those of(32.56±3.58)and(38.32±2.71)°in the control group;the differences were statistically significant(P<0.05).VAS score of(2.17±0.93)points in the study group at the time of first ambulation was lower than that of(3.24±1.07)points in the control group;AOFAS score of(91.79±5.26)points in the study group at 6 months after surgery was higher than that of(85.15±4.88)points in the control group;all differences were statistically significant(P<0.05).The incidence of postoperative complications was 7.69%(2/26)in the study group,which was not statistically significant when compared with that of 3.85%(1/26)in the control group(χ^(2)=0.354,P>0.05).All patients who developed complications were treated with antibiotics and their infections were cured.Conclusion The application of continuous passive exercise after ankle fracture surgery can promote the improvement of the patient's ankle function,reduce the pain during the first ambulation,and will not increase the risk of incisional infection in the patient,which can be promoted as an effective way of rehabilitation training after ankle fracture.