早期CPM锻炼对髌骨粉碎性骨折术后膝关节功能的影响

摘要

目的:探讨早期CPM机锻炼对髌骨粉碎性骨折术后膝关节功能的影响及安全性分析.方法:回顾性分析2012年5月-2014年12月本院行手术治疗单侧髌骨粉碎性骨折患者60例,随机分为两组,每组各30例.对照组采用支具固定及主动功能锻炼,试验组在对照组功能锻炼的基础上进行早期CPM机被动锻炼,观察术后第1天、1周、1月及3月的视觉模拟评分法(VAS)评分及膝关节损伤和骨关节炎评分(KOOS评分).结果:两组均获得临床完整随访,经过治疗后,两组的VAS评分比较差异无统计学意义(P=0.051);早期(术后第1天和1周)试验组VAS评分高于对照组,两组比较差异有统计学意义(P<0.05);术后1月和3月两组间的VAS评分比较差异无统计学意义(P>0.05).两组的术后KOOS评分比较,差异有统计学意义(P=0.012);试验组KOOS评分除第1天外均明显高于对照组,差异均有统计学意义(P<0.05).结论:早期CPM锻炼可以改善髌骨粉碎性骨折术后膝关节功能,值得临床推广.%Objective:To investigate the knee function and safety of early continuous passive motion exercise after operation of comminuted fracture in patella.Method:60 patients with comminuted fracture in patella were retrospectively analyzed from May 2012 to December 2014,they were randomly divided into two groups, 30 cases in each group. The control group was given brace immobilization and initiative functional exercise, while the experimental group was treated with early continuous passive motion exercise on the basis of control group. The postoperative VAS score and KOOS score of two groups were recorded in the first day,the first week,the first month and the third month.Result:All patients got followed-up,there was no significant difference on VAS score after operation of two groups(P=0.051). After operation,the VAS score in the first day and the first week of experimental group were higher than that in the control group, the differences were statistically significant(P<0.05),but no differences in the first and third month of two groups (P>0.05).After operation,there was significant difference on KOOS score of two groups(P=0.012);the KOOS score in the first week , first and third month of experimental group were higher than that of the control group, the differences were statistically significant(P<0.05), but no differences on first day of two groups.Conclusion:The early continuous passive motion exercise after operation of comminuted fracture in patella maybe prefer and can improve the prognosis significantly.