目的:观察四黄散联合间断垂直钢丝缝合加张力带对髌骨下极骨折患者膝关节活动度及骨折愈合时间的影响。方法:选取2021年9月至2022年9月丰城市中医院收治的髌骨下极骨折患者40例,按照随机数字表法分为对照组和试验组,每组20例。两组患者...目的:观察四黄散联合间断垂直钢丝缝合加张力带对髌骨下极骨折患者膝关节活动度及骨折愈合时间的影响。方法:选取2021年9月至2022年9月丰城市中医院收治的髌骨下极骨折患者40例,按照随机数字表法分为对照组和试验组,每组20例。两组患者均给予切开复位内固定,对照组给予间断垂直钢丝缝合联合张力带治疗,试验组给予四黄散联合间断垂直钢丝缝合加张力带治疗。观察两组患者术后6周、3个月、6个月、1年及末次随访时膝关节疼痛评分、屈伸活动范围(range of motion, ROM)、Bostman评分、骨折愈合时间、各项临床指标及并发症发生情况。结果:试验组术后6周、3个月、6个月、1年膝关节疼痛评分均低于对照组,差异有统计学意义(P<0.05)。试验组术后6周、3个月、6个月、1年ROM、Bostman评分高于对照组,差异有统计学意义(P<0.05)。试验组术后1年骨折愈合时间、各项临床指标均优于对照组,并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:四黄散联合间断垂直钢丝缝合加张力带能改善髌骨下极骨折患者膝关节功能,降低术后并发症发生率,促进骨折早日愈合。展开更多
Total knee arthroplasty is highly successful,in part due to range of motion(RoM)recovery.This is typically estimated goniometrically/visually by physical therapists(PTs)in the clinic,which is imprecise.Accordingly,a v...Total knee arthroplasty is highly successful,in part due to range of motion(RoM)recovery.This is typically estimated goniometrically/visually by physical therapists(PTs)in the clinic,which is imprecise.Accordingly,a validated inertial measurement unit(IMU)method for capturing knee RoM was deployed assessing postoperative RoM both in and outside of the clinical setting.The study's objectives were to evaluate the feasibility of continuously capturing knee RoM pre-/post-op via IMUs,dividing data into PT/non-PT portions of each day,and comparing PT/non-PT metrics.We hypothesized IMU-based clinical knee RoM would differ from IMU-based knee RoM captured outside clinical settings.10 patients(3 M,69±13 years)completed informed consent documents following ethics board approval.A validated IMU method captured long duration(8–12 h/day,~50 days)knee RoM pre-/post-op.Post-op metrics were subdivided(PT versus non-PT).Clinical RoM and patient reported outcome measures were also captured.Compliance and clinical disruption were evaluated.ANOVA compared post-op PT and non-PT means and change scores.Maximum flexion during PT was less than outside PT.PT stance/swing RoM and activity level were greater than outside PT.No temporal variable differences were found PT versus non-PT.IMU RoM measurements capture richer information than clinical measures.Maximum PT flexion was likely less than non-PT due to the exercises completed(i.e.high passive RoM vs.low RoM gait).PT gait flexion likely exceed non-PT because of‘white coat effects’wherein patients are closely monitored clinically.This implies data captured clinically represents optimum performance whereas data captured non-clinically represents realistic performance.展开更多
文摘目的:观察四黄散联合间断垂直钢丝缝合加张力带对髌骨下极骨折患者膝关节活动度及骨折愈合时间的影响。方法:选取2021年9月至2022年9月丰城市中医院收治的髌骨下极骨折患者40例,按照随机数字表法分为对照组和试验组,每组20例。两组患者均给予切开复位内固定,对照组给予间断垂直钢丝缝合联合张力带治疗,试验组给予四黄散联合间断垂直钢丝缝合加张力带治疗。观察两组患者术后6周、3个月、6个月、1年及末次随访时膝关节疼痛评分、屈伸活动范围(range of motion, ROM)、Bostman评分、骨折愈合时间、各项临床指标及并发症发生情况。结果:试验组术后6周、3个月、6个月、1年膝关节疼痛评分均低于对照组,差异有统计学意义(P<0.05)。试验组术后6周、3个月、6个月、1年ROM、Bostman评分高于对照组,差异有统计学意义(P<0.05)。试验组术后1年骨折愈合时间、各项临床指标均优于对照组,并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:四黄散联合间断垂直钢丝缝合加张力带能改善髌骨下极骨折患者膝关节功能,降低术后并发症发生率,促进骨折早日愈合。
基金This was work supported by the National Center for Advancing Translational Sciences of the National Institutes of Health[UL1TR001086].
文摘Total knee arthroplasty is highly successful,in part due to range of motion(RoM)recovery.This is typically estimated goniometrically/visually by physical therapists(PTs)in the clinic,which is imprecise.Accordingly,a validated inertial measurement unit(IMU)method for capturing knee RoM was deployed assessing postoperative RoM both in and outside of the clinical setting.The study's objectives were to evaluate the feasibility of continuously capturing knee RoM pre-/post-op via IMUs,dividing data into PT/non-PT portions of each day,and comparing PT/non-PT metrics.We hypothesized IMU-based clinical knee RoM would differ from IMU-based knee RoM captured outside clinical settings.10 patients(3 M,69±13 years)completed informed consent documents following ethics board approval.A validated IMU method captured long duration(8–12 h/day,~50 days)knee RoM pre-/post-op.Post-op metrics were subdivided(PT versus non-PT).Clinical RoM and patient reported outcome measures were also captured.Compliance and clinical disruption were evaluated.ANOVA compared post-op PT and non-PT means and change scores.Maximum flexion during PT was less than outside PT.PT stance/swing RoM and activity level were greater than outside PT.No temporal variable differences were found PT versus non-PT.IMU RoM measurements capture richer information than clinical measures.Maximum PT flexion was likely less than non-PT due to the exercises completed(i.e.high passive RoM vs.low RoM gait).PT gait flexion likely exceed non-PT because of‘white coat effects’wherein patients are closely monitored clinically.This implies data captured clinically represents optimum performance whereas data captured non-clinically represents realistic performance.
