关节持续被动活动仪在踝关节骨折患者术后康复中的应用

doi:10.3760/cma.j.cn441417-20241127-11025

摘要/Abstract

摘要：

目的　分析关节持续被动活动仪在踝关节骨折患者术后康复中的应用价值。方法　选择2023年9月至2024年9月安康市中心医院收治的踝关节骨折患者90例，依据分层抽样法分为两组，每组45例。对照组中男27例，女18例；年龄34～55（45.19±4.16）岁；Lange-Hansen分型：旋后外旋型17例、旋后内收型7例、旋前外旋型13例、旋前外展型8例。观察组中男29例，女16例；年龄32～54（44.72±4.27）岁；Lange-Hansen分型：旋后外旋型19例、旋后内收型5例、旋前外旋型11例、旋前外展型10例。两组均接受切开复位固定术治疗，对照组术后接受常规康复训练，观察组在对照组基础上接受踝关节持续被动活动仪治疗，两组均干预至术后3个月。比较两组踝关节功能［美国矫形外科足踝协会（AOFAS）踝-后足评分、Olerud Molander踝关节评分（OMAS）］、踝关节背伸和跖屈活动度、步行参数［标准化单支撑期时长、步速、步宽、步长］、并发症发生率。采用χ2检验、t检验进行统计学分析。结果　干预后，观察组AOFAS踝-后足评分、OMAS均高于对照组［（83.15±7.43）分比（77.52±6.85）分、（80.46±6.12）分比（74.18±5.65）分］（t=3.737、5.058，均P<0.05）；观察组踝关节背伸、跖屈活动度均大于对照组［（15.95±1.08）°比（10.42±0.87）°、（41.84±1.96）°比（37.12±1.27）°］（t=26.749、13.557，均P<0.05）；观察组标准化单支撑期时长、步速、步长均大于对照组［（26.18±4.15）%比（21.69±3.77）%、（1.18±0.23）m/s比（0.94±0.17）m/s、（0.64±0.21）m比（0.53±0.18）m］（t=5.372、5.629、2.668，均P<0.05）。观察组并发症发生率低于对照组［4.44%（2/45）比20.00%（9/45）］（χ2=5.075，P=0.024）。结论　应用关节持续被动活动仪可改善踝关节骨折患者术后踝关节功能，提升踝关节背伸和跖屈活动度，促进步行能力的提高，降低并发症发生率。

关键词: 踝关节骨折, 术后康复, 踝关节功能, 关节持续被动活动仪

Abstract:

Objective　To analyze the application value of an appliance for delivering continuous passive motion to the joint in the postoperative rehabilitation of ankle fracture patients. Methods　Ninety patients with ankle fractures admitted to Ankang Central Hospital from September 2023 to September 2024 were selected and were divided into two groups according to the stratified sampling method, with 45 cases in each group. In the control group, there were 27 males and 18 females, aged 34-55 (45.19±4.16) years, Lange-Hansen classification: 17 cases of supination-external rotation, 7 cases of supination-adduction, 13 cases of pronation-external rotation, and 8 cases of pronation-abduction. In the observation group, there were 29 males and 16 females, aged 32-54 (44.72±4.27) years, Lange-Hansen classification: 19 cases of supination-external rotation, 5 cases of supination-adduction, 11 cases of pronation-external rotation, and 10 cases of pronation-abduction. Both groups underwent open reduction and internal fixation. The control group received routine rehabilitation training after surgery, and the observation group received intervention with an appliance for delivering continuous passive motion to the ankle joint on the basis of the control group. Both groups were intervened until 3 months after surgery. The ankle joint functions [ankle-hindfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS) and Olerud Molander Ankle Score (OMAS)], ranges of motion of ankle dorsiflexion and plantar flexion, walking parameters (standardized single support period duration, step speed, step width, and step length), and incidence of complications were compared between the two groups. Statistical analysis was performed using the χ² test and the t test. Results　After intervention, the AOFAS ankle-hindfoot score and OMAS in the observation group were higher than those in the control group [(83.15±7.43) points vs. (77.52±6.85) points, (80.46±6.12) points vs. (74.18±5.65) points] (t=3.737 and 5.058; both P<0.05); the ranges of motion of ankle dorsiflexion and plantar flexion in the observation group were greater than those in the control group [(15.95±1.08)° vs. (10.42±0.87)°, (41.84±1.96)° vs. (37.12±1.27)°] (t=26.749 and 13.557; both P<0.05); the standardized single support period duration, step speed, and step length in the observation group were all greater than those in the control group [(26.18±4.15)% vs. (21.69±3.77)%, (1.18±0.23) m/s vs. (0.94±0.17) m/s, (0.64±0.21) m vs. (0.53±0.18) m] (t=5.372, 5.629, and 2.668, all P<0.05). The incidence of complications in the observation group was lower than that in the control group [4.44% (2/45) vs. 20.00% (9/45)] (χ²=5.075, P=0.024). Conclusion　Applying an appliance for delivering continuous passive motion to the joint in the postoperative rehabilitation of ankle fracture patients can improve the ankle joint function, increase the ranges of ankle dorsiflexion and plantar flexion, promote the improvement in walking ability, and reduce the incidence of complications.

Key words: Ankle fractures, , Postoperative rehabilitation, , Ankle function, , Appliance for delivering continuous passive motion to the joint

成康张友波. 关节持续被动活动仪在踝关节骨折患者术后康复中的应用 [J]. 国际医药卫生导报, 2025, 31(11): 1895-1899.

Cheng Kang, Zhang Youbo.

Application of an appliance for delivering continuous passive motion to the joint in the postoperative rehabilitation of ankle fracture patients [J]. International Medicine and Health Guidance News, 2025, 31(11): 1895-1899.

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