股骨粗隆间骨折PFNA术后功能康复效果观察
发布时间：2018-11-05 18:10
【摘要】：目的:分析不同理念指导下的康复功能锻炼应用于股骨粗隆间骨折术后对患者功能康复的促进效果,并证实“动静平衡”原则与AO无痛原则下自主练习这两种不同理念指导下股骨粗隆间骨折PFNA术后髋关节功能康复的临床效果是否有差异,为患者的术后功能康复提供一种更系统、更有效的方法。方法:病例选择成都市青白江区人民医院骨外科2014年6月至2016年6月期间收治的72例股骨粗隆间骨折PFNA内固定患者,对72例患者进行随机分组,划分为研究组与对照组,两组各36例。研究组36例股骨粗隆间骨折PFNA内固定患者在“动静平衡”原则下指导进行康复功能锻炼,研究组36例患者中,19例男性患者,17例女性患者;年龄在60-89岁范围内,其中8例患者的年龄在60-69岁范围内,20例患者的年龄在70-79岁范围内,8例患者的年龄在80-89岁范围内;致伤原因:2例坠落伤,25例摔伤,9例交通事故伤;股骨粗隆间骨折AO分型:7例A1型,20例A2型,9例A3型。对照组36例股骨粗隆间骨折PFNA内固定患者在AO无痛原则下自主进行康复功能锻炼,对照组36例患者中,20例男性患者,16例女性患者;年龄在60-89岁范围内,其中9例患者的年龄在60-69岁范围内,21例患者的年龄在70-79岁范围内,6例患者的年龄在80-89岁范围内;致伤原因:6例坠落伤,20例摔伤,10例交通事故伤;股骨粗隆间骨折AO分型:10例A1型,21例A2型,5例A3型。对比两组股骨粗隆间骨折PFNA内固定患者的髋关节Harris评分、髋关节活动优良率与术后并发症发生率,判断两组患者术后康复锻炼的效果。结果:研究组36例股骨粗隆间骨折PFNA内固定患者的Harris评分、髋关节活动优良率分别为(91.34±6.87)分、88.89%,对照组36例股骨粗隆间骨折PFNA内固定患者的Harris评分、髋关节活动优良率分别为(79.18±11.69)、66.67%,与对照组相比较而言,研究组36例股骨粗隆间骨折PFNA内固定患者的髋关节活动优良率明显更高;且与对照组相比较而言,研究组36例股骨粗隆间骨折PFNA内固定患者的肌肉肌腱软组织粘连、关节僵硬等并发症的发生率明显更低。两组差异有统计学意义(P0.05)。结论:“动静平衡”理念指导下股骨粗隆间骨折PFNA内固定术后康复锻炼的效果明显优于AO无痛原则下患者自主进行功能锻炼,有利于进一步促进股骨粗隆间骨折PFNA内固定患者的髋关节功能恢复,能够在很大程度上降低一系列术后并发症发生率,提高患者生存质量,“动静平衡”理念指导下股骨粗隆间骨折PFNA术后康复锻炼是一种安全、简单且有效的快速康复方法,值得在临床一线医护工作中推广运用。
[Abstract]:Objective: to analyze the effect of rehabilitation exercise guided by different ideas on the functional rehabilitation of patients with intertrochanteric fracture of femur. It was also confirmed that there were differences in the clinical effects of hip joint function rehabilitation after PFNA operation between the principle of "static balance" and the principle of AO painless self-exercise under the guidance of the two different concepts of hip joint function rehabilitation after PFNA operation for intertrochanteric fracture of femur. To provide a more systematic and effective method for postoperative functional rehabilitation. Methods: from June 2014 to June 2016, 72 patients with intertrochanteric fracture treated by PFNA were randomly divided into study group and control group. There were 36 cases in each group. In the study group, 36 patients with PFNA internal fixation of intertrochanteric fracture underwent rehabilitation exercise under the principle of "dynamic balance". In the study group, there were 19 male patients and 17 female patients. The age ranged from 60 to 89 years, of which 8 patients were within the age range of 60-69 years, 20 patients were within the age range of 70-79 years, and 8 patients were within the age range of 80-89 years. AO classification of femoral intertrochanteric fracture: 7 cases were type A1, 20 cases were type A2, 9 cases were type A3. In the control group, 36 patients with intertrochanteric fracture of femur were treated with PFNA internal fixation under the principle of painless AO. In the control group, 20 cases were male and 16 cases were female. The age ranged from 60 to 89 years, of which 9 patients were within the age range of 60-69 years, 21 patients were within the age range of 70-79 years, and 6 patients were within the age range of 80-89 years. AO classification of femoral intertrochanteric fracture: A1 type in 10 cases, A2 type in 21 cases, A3 type in 5 cases. The Harris score of hip joint, the excellent and good rate of hip joint movement and the incidence of postoperative complications were compared between the two groups of patients with intertrochanteric fracture with PFNA. Results: in the study group, the Harris scores of 36 patients with intertrochanteric fracture of femur and the excellent and good rate of hip motion were (91.34 卤6.87) and 88.89, respectively. The Harris scores of 36 cases of PFNA internal fixation of intertrochanteric fracture of femur in the control group were evaluated. The excellent and good rates of hip motion were (79.18 卤11.69) and 66.67, respectively. Compared with the control group, 36 patients with intertrochanteric fracture in the study group had higher excellent and good rate of hip motion than those in the control group. Compared with the control group, the incidence of muscle tendon soft tissue adhesion and joint stiffness in 36 patients with intertrochanteric fracture treated with PFNA in the study group was significantly lower than that in the control group. The difference between the two groups was statistically significant (P0.05). Conclusion: under the guidance of the idea of "dynamic balance", the effect of rehabilitation exercise after PFNA internal fixation of femoral intertrochanteric fracture is obviously better than that of AO without pain. It is helpful to further promote the recovery of hip joint function in patients with intertrochanteric fracture treated with PFNA, reduce a series of postoperative complications, and improve the quality of life of patients with intertrochanteric fracture. The idea of "static and dynamic balance" is a safe, simple and effective method for rapid rehabilitation of intertrochanteric fracture after PFNA, which is worth popularizing in clinical first-line medical work.
【学位授予单位】：西南医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3
本文编号：2312914
[Abstract]:Objective: to analyze the effect of rehabilitation exercise guided by different ideas on the functional rehabilitation of patients with intertrochanteric fracture of femur. It was also confirmed that there were differences in the clinical effects of hip joint function rehabilitation after PFNA operation between the principle of "static balance" and the principle of AO painless self-exercise under the guidance of the two different concepts of hip joint function rehabilitation after PFNA operation for intertrochanteric fracture of femur. To provide a more systematic and effective method for postoperative functional rehabilitation. Methods: from June 2014 to June 2016, 72 patients with intertrochanteric fracture treated by PFNA were randomly divided into study group and control group. There were 36 cases in each group. In the study group, 36 patients with PFNA internal fixation of intertrochanteric fracture underwent rehabilitation exercise under the principle of "dynamic balance". In the study group, there were 19 male patients and 17 female patients. The age ranged from 60 to 89 years, of which 8 patients were within the age range of 60-69 years, 20 patients were within the age range of 70-79 years, and 8 patients were within the age range of 80-89 years. AO classification of femoral intertrochanteric fracture: 7 cases were type A1, 20 cases were type A2, 9 cases were type A3. In the control group, 36 patients with intertrochanteric fracture of femur were treated with PFNA internal fixation under the principle of painless AO. In the control group, 20 cases were male and 16 cases were female. The age ranged from 60 to 89 years, of which 9 patients were within the age range of 60-69 years, 21 patients were within the age range of 70-79 years, and 6 patients were within the age range of 80-89 years. AO classification of femoral intertrochanteric fracture: A1 type in 10 cases, A2 type in 21 cases, A3 type in 5 cases. The Harris score of hip joint, the excellent and good rate of hip joint movement and the incidence of postoperative complications were compared between the two groups of patients with intertrochanteric fracture with PFNA. Results: in the study group, the Harris scores of 36 patients with intertrochanteric fracture of femur and the excellent and good rate of hip motion were (91.34 卤6.87) and 88.89, respectively. The Harris scores of 36 cases of PFNA internal fixation of intertrochanteric fracture of femur in the control group were evaluated. The excellent and good rates of hip motion were (79.18 卤11.69) and 66.67, respectively. Compared with the control group, 36 patients with intertrochanteric fracture in the study group had higher excellent and good rate of hip motion than those in the control group. Compared with the control group, the incidence of muscle tendon soft tissue adhesion and joint stiffness in 36 patients with intertrochanteric fracture treated with PFNA in the study group was significantly lower than that in the control group. The difference between the two groups was statistically significant (P0.05). Conclusion: under the guidance of the idea of "dynamic balance", the effect of rehabilitation exercise after PFNA internal fixation of femoral intertrochanteric fracture is obviously better than that of AO without pain. It is helpful to further promote the recovery of hip joint function in patients with intertrochanteric fracture treated with PFNA, reduce a series of postoperative complications, and improve the quality of life of patients with intertrochanteric fracture. The idea of "static and dynamic balance" is a safe, simple and effective method for rapid rehabilitation of intertrochanteric fracture after PFNA, which is worth popularizing in clinical first-line medical work.
【学位授予单位】：西南医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3
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