等速肌力训练对胫骨平台SchatzkerⅠ~Ⅲ型骨折患者术后恢复的早期疗效分析

Early effects of isokinetic muscle strength training on postoperative recovery of patients with Schatzker typeⅠ-Ⅲtibial plateau fractures

目的探讨等速肌力训练对胫骨平台SchatzkerⅠ~Ⅲ型骨折患者术后恢复的疗效。方法分析2018年3月至2021年3月在我院收治的60例胫骨平台SchatzkerⅠ~Ⅲ型骨折患者的临床资料,其中男45例,女15例,平均年龄(43.8±10.86)岁。依据随机分组,30例患者术后行等速肌力训练(等速组),30例在手术治疗后行常规康复锻炼(常规组)。比较两组一般资料和术后6个月等速肌力峰力矩(peak torque,PT)、总功(total work,TW)评定和术后6个月及12个月的美国特种外科医院(hospital for special surgery,HSS)膝关节功能评分。结果等速组患膝屈肌、伸肌PT明显高于常规组[屈曲60°/s:(79.34±7.32)N·m vs.(69.33±7.46)N·m,屈曲120°/s:(71.08±6.34)N·m vs.(61.55±9.34)N·m,伸展60°/s:(160.95±10.13)N·m vs.(148.06±16.96)N·m,伸展120°/s:(136.35±11.21)N·m vs.(125.85±12.59)N·m],等速组患膝屈肌、伸肌TW均明显大于常规组[屈曲60°/s:(549.51±47.70)J vs.(485.80±49.17)J,屈曲120°/s:(439.68±55.42)J vs.(382.38±56.43)J,伸展60°/s:(965.70±78.09)J vs.(872.69±88.70)J,伸展120°/s:(825.50±70.23)J vs.(730.16±76.01)J],差异均有统计学意义(P<0.05);术后6个月、12个月两组HSS评分较术前均有明显提升(等速组:86.97±6.22 vs.36.89±9.24、96.10±2.99 vs.36.89±9.24,常规组:70.87±6.61 vs.37.53±9.05、88.40±5.49 vs.37.53±9.05),差异有统计学意义(P<0.05);术后6个月及12个月等速组HSS评分显著优于常规组(86.97±6.22 vs.70.87±6.61、96.10±2.99 vs.88.40±5.49),两组间差异有统计学意义(P<0.05);常规组出现术后并发症的患者例数为7例,远多于等速组1例。结论等速肌力训练有利于胫骨平台SchatzkerⅠ~Ⅲ型骨折患者术后患膝屈、伸肌群肌力及膝关节功能恢复。

Objective To explore the efficacy of isokinetic muscle strength training on postoperative recovery of patients with Schatzker typeⅠ-Ⅲtibial plateau fractures.Methods The clinical data of 60 patients with SchatzkerⅠ-Ⅲtibial plateau fractures admitted to Yantai Affiliated Hospital of Binzhou Medical College from March 2018 to March 2021 were analyzed,including 45 males and 15 females with an average age of(43.8±10.86)years.Grouping by random,30 patients were treated with isokinetic muscle strength training after surgery(isokinetic group),and 30 patients did conventional rehabilitation exercises after surgery(conventional group).The general data,isokinetic peak torque(PT)and total work(TW)evaluation at 6 months after surgery,and Hospital for Special Surgery(HSS)knee function scores at 6 and 12 months after surgery were compared between the two groups.Results The PT of flexor and extensor muscles of the isokinetic group was significantly higher than that of the conventional group[flexor muscles,60°/s:(79.34±7.32)N·m vs.(69.33±7.46)N·m,120°/s:(71.08±6.34)N·m vs.(61.55±9.34)N·m;extensor muscles 60°/s:(160.95±10.13)N·m vs.(148.06±16.96)N·m,120°/s:(136.35±11.21)N·m vs.(125.85±12.59)N·m],and the TW of the isokinetic group was significantly higher than that of the conventional group[flexor muscles,60°/s:(549.51±47.70)J vs.(485.80±49.17)J,120°/s:(439.68±55.42)J vs.(382.38±56.43)J;extensor muscles,60°/s:(965.70±78.09)J vs.(872.69±88.70)J,120°/s:(825.50±70.23)J vs.(730.16±76.01)J],with statistically significant differences(P<0.05).The HSS scores in both groups were significantly improved at 6 months and 12 months after operation(isokinetic group:86.97±6.22 vs.36.89±9.24,96.10±2.99 vs.36.89±9.24;conventional group:70.87±6.61 vs.37.53±9.05,88.40±5.49 vs.37.53±9.05),and the differences were statistically significant(P<0.05).The HSS score of the isokinetic group was significantly better than that of the conventional group at 6 and 12 months after operation(86.97±6.22 vs.70.87±6.61,96.10±2.99 vs.88.40±5.49),with statistically significant differences between the two groups(P<0.05).The number of cases with postoperative complications in the conventional group was 7,much more than 1 case in the isokinetic group.Conclusions Isokinetic muscle strength training benefits the recovery of knee flexor-extensor muscle strength and knee joint function after Schatzker typeⅠ-Ⅲtibial plateau fractures.