期刊文献+

创伤后膝关节功能障碍治疗的初期临床研究 被引量:27

preliminary clinical study of the management of posttraumatic knee joint dysfunction
下载PDF
导出
摘要 [目的]探讨创伤后膝关节功能障碍(PKJD)的综合治疗及疗效。[方法]2001年-2005年共治疗创伤后膝关节功能障碍患者40例,42膝。治疗包括系统正规的康复手段以及手术介入。康复手段包括肌力训练、关节活动范围训练、神经生理治疗技术、身体适应性训练等;手术介入包括传统的伸膝装置黏连松解、内固定物取出同时黏连松解、小切口有限股四头肌成形+关节镜松解、Ilizarov技术。[结果]42膝住院前均未进行正规的康复治疗,入院后30膝行康复治疗,12膝手术治疗。平均膝关节活动度(ROM)入院时0°-9.2°-58.1°,股四头肌肌力Ⅲ-Ⅳ级;出院时0°-4.9°-88.9°,股四头肌力Ⅴ级,治疗前后膝关节ROM相比较有统计学差异(P〈0.01)。21例出院时仍残留5°-10°膝关节伸直迟滞,2例应用Ilizarov技术治疗效果不满意,l例治疗过程中出现精神抑郁症。22例平均19.3个月随访时膝关节均能伸直到0°,其中屈曲≥120°者15例。[结论]原始创伤处理不当和治疗后未行早期系统正规的康复训练是造成创伤后膝关节功能障碍不可忽视的原因,其治疗比较棘手,是一个长期过程,康复治疗和适当的手术介入可取得良好的效果。 [ Objective ] To evaluate the comprehensive clinical management of posttraumatic knee joint dysfunction (PKJD). [ Method ] From 2001 to 2005,40 patients (42 knees) with posttraumatic knee joint dysfunction were treated with conservative procedures including training of muscle strength,range of motion ( ROM ), proprioception or neuromuscular control, general physical condition ; and surgical procedures including Thompson's procedures, improved Judet's technique, extra-articular mini - invasive quadricepsplasty + intra-articular arthrofibroticlysis, Ilizarov technique.[Resuit] All of the 42 cases did not receive systematic rehabilitation therapy before they came in hospital. At our center,30 of them were managed conservatively and 12 of them surgically. The average ROM of the involved knee was 0° - 9.2° - 58.1 at the time of admission,and 0° - 4. 9° - 88.9° when they were discharged, the difference is significant statistically (P 〈 0.01 ) . Twenty-one cases remained 5°- 10° knee extension lag. Two cases who were treated with Iizarove technique showed uncomfortable results, and Ⅰ cases got psychosocical problem. Twenty-two eases were followed up in average 19. 3 months and all the knees were able to extend to 0°.[ Conclusion] Unable to receive ideal surgical treatment after trauma and systematic rehabilitation therapy after surgery are the very important factors of posttraumatic knee joint dysfunction, the management of PKJD is difficult and time consuming, systematic rehabilitation programs and adequate surgical intervention induce good resuhs.
出处 《中国矫形外科杂志》 CAS CSCD 北大核心 2007年第2期94-97,I0002,共5页 Orthopedic Journal of China
关键词 创伤 膝关节 功能障碍 治疗 trauma knee joint dysfunction treatment
  • 相关文献

参考文献10

  • 1Gaston P,Will EM,Kesting JF.Recovery of knee function following fracture of the tibial plateau[J].J Bone Joint Surg,2005,87:1233-1236.
  • 2Mira A J,Maekley K,Greer Ⅲ RB.A critical analysis of quadriceps function after femoral shaft fracture in adults[J].J Bone Joint Surg,1980,62:61 -67.
  • 3Ali AM,Villafuerte J,Hashmi M,et al.Judet's quadricepsplasty,surgical technique,and results in limb reconstruction[J].Clin Orthop,2003,415:214-220.
  • 4尹清,武继祥,刘宏亮,汪琴.综合康复治疗骨折后膝关节功能障碍的疗效分析[J].中华物理医学与康复杂志,2004,26(5):304-306. 被引量:93
  • 5Lindenfeld TN,Bach BR Jr,Wojtys EM.Reflex sympathetic dystrophy and pain dysfunction in the lower extremity[J],Instr Course Lect,1997,46:261-268.
  • 6Rosenberger PH,Jokl P,Ickovics J.Psychosocial factor and surgical outcomes:an evidence-based literature review[J].K Am Acad Orthop Surg,2006,14:397-405.
  • 7Judet R.Mobilisation of the stiff knee[J].J Bone Joint Surg,1959,41:856 -857.
  • 8Rodriguez Blanco CE,Leon HO,Guthrie TB.Endoscopic quadricepsplasty:a new surgical technique[J].Arthroscopy,2001,17:504 -509.
  • 9王建华,赵金忠,何耀华,皇甫小桥,袁峰,彭晓春.严重膝关节伸直挛缩的微创治疗[J].中华骨科杂志,2006,26(5):300-304. 被引量:10
  • 10刘宁,刘建民,梁振雷,彭庆州,赵明宇,胡斌.膝关节僵直的关节镜下松解术[J].中国矫形外科杂志,2005,13(15):1146-1149. 被引量:17

二级参考文献21

  • 1Mariani PP, Santori N, Rovere P, et al. Histological and structural study of the adhesive tissue in knee fibroarthrosis: a clinical-pathological correlation [J]. Arthroscopy, 1997,13 ( 3 ) :313-318.
  • 2Hather BM,Adams GR,Tesch PA,et al.Skeletal muscle responses to lower limb suspension in humans.J Appl Physiol,1992,72:1493-1498.
  • 3McKoy BE,Hartsock LA.Physical impairment and functional outcome in patients having lower extremity fractures after age 65.J South Orthop Assoc,2000,9:161-168.
  • 4Kuptniratsaikul V,Tosayanonda O,Nilganuwong S,et al.The efficacy of a muscle exercise program to improve functional performance of the knee in patients with osteoarthritis.J Med Assoc Thai,2002,85:33-40.
  • 5Henriksson M,Rockborn P,Good L.Range of motion training in brace vs.plaster immobilization after anterior cruciate ligament reconstruction:a prospective randomized comparison with a 2-year follow-up.Scad J Med Sci Sports,2002,12:73-80.
  • 6Milner SA,Davis TR,Muir KR,et al.Long-term outcome after tibial shaft fracture:is malunion important? J Bone Joint Surg Am,2002,84:971-980.
  • 7Fransen M,McConnell S,Bell M.Therapeutic exercise for people with osteoarthritis of the hip or knee.A systematic review.J Rheumatol,2002,29:1737-1745.
  • 8Nicoll EA.Quadricepsplasty.J Bone Joint Surg (Br),1963,45:483-490.
  • 9Moore TJ,Harwin C,Green SA,et al.The results of quadricepsplasty on knee motion following femoral fractures.J Trauma,1987,27:49-51.
  • 10Ebraheim NA,DeTroye RJ,Saddemi SR.Results of Judet quadricepsplasty.J Orthop Trauma,1993,7:327-330.

共引文献114

同被引文献258

引证文献27

二级引证文献129

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部