GSH交锁髓内钉治疗股骨远端骨折术后早期康复

Early Rehabilitation after the Distal Femur Fractures Treated by GSH Intramedullary Interlocking Nail

目的 :评价股骨髁上倒打交锁髓内钉 (GSH)治疗股骨远端骨折术后早期应用CPM锻练膝关节的效果。方法 :采用GSH治疗股骨远端骨折患者 118例 ,术后应用CPM早期康复锻炼的患者 72例 (CPM组 ) ,按常规治疗 4 6例 (常规组 )。结果 :术后 3个月 ,根据Neer膝关节功能评分标准 ,CPM组患者中 ,优 38例 ,良 2 6例 ,可 8例 ,优良率 88.9% ;常规组患者中 ,优 2例 ,良 9例 ,可 33例 ,差 2例 ,优良率 2 3.9%。术后 1年 ,CPM组患者中 ,优 37例 ,良 2 8例 ,可 7例 ,优良率 90 .3% ;常规组患者中优 2例 ,良 10例 ,可 32例 ,差 2例 ,优良率 2 6 .1%。结论 :采用GSH交锁髓内钉治疗股骨远端骨折术后患者早期应用CPM锻炼是防止膝关节功能障碍的理想方法。

Objective: To assess the clinical outcomes of exercising the knee early with CPM after the distal femur fractures treated by GSH intramedullary interlocking nail. Methods: From March 1998 to August 2002, 118 cases of distal femur fractures were treated by GSH intramedullary interlocking nail. The fracture was classified according to AO/ASIF: 48 cases of type A1, 26 cases of type A2, 19 cases of type A3, 18 cases of type C1 and 7 cases of type C2. The 72 patients were exercised with CPM after the distal femur fractures treated by GSH intramedullary interlocking nail (CPM group) and 46 patients (control group) were not exercised with CPM after the distal femur fractures treated by GSH intramedullary interlocking nail. Results: The functional scores: In the CPM group after three months, 38 were excellent, 26 good, 8 fair and 0 bad with an excellent rate of 88.89 %; In the control group after three months, 2 were excellent, 9 good, 33 fair and 2 bad with an excellent rate of 23.91 %. In the CPM group after one year, 37 were excellent, 28 good, 7 fair and 0 bad with an excellent rate of 90.28 %; in the control group after one year, 2 were excellent, 10 good, 32 fair and 2 bad with an excellent rate of 26.09 %.Conclusion: It is a good way to exercise the knee early with CPM after the distal femur fractures treated by GSH intramedullary interlocking nail.