Application of an appliance for delivering continuous passive motion to the joint in the postoperative rehabilitation of ankle fracture patients

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

Abstract

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

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

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.

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.

References

[1]盛学鑫,张明师,周子斐,等.踝关节骨折严重程度及预后功能与细胞因子水平的相关性分析[J].中华骨与关节外科杂志,2024,17(4):354-360. DOI:10.3969/j.issn.2095-9958.2024.04.11.

[2]刘玉波,张会增,张同润,等.踝关节骨折术后踝穴形态变化与踝关节功能的相关因素分析[J].中国组织工程研究,2022,26(3):440-445.

[3]郑良孝,陈东亮,刘金伟,等.切开复位内固定联合三角韧带加强修补治疗踝关节骨折合并三角韧带损伤的疗效[J].中国老年学杂志,2022,42(20):5013-5016. DOI:10.3969/j.issn.1005-9202.2022.20.035.

[4]Mosca M, Buda R, Ceccarelli F, et al. Ankle joint re-balancing in the management of ankle fracture malunion using fibular lengthening: prospective clinical-radiological results at mid-term follow-up[J]. Int Orthop, 2021, 45(2):411-417. DOI: 10.1007/s00264-020-04690-y.

[5]Li N, Yang F, Parthasarathy S, et al. Patterning neuroepithelial cell sheet via a sustained chemical gradient generated by localized passive diffusion devices[J]. ACS Biomater Sci Eng, 2021, 7(4):1713-1721. DOI: 10.1021/acsbiomaterials.0c01365.

[6]沈文斌,张友,文明.膝关节持续被动活动康复仪在胫骨骨折患者康复中的应用效果[J].现代仪器与医疗,2022,28(5):65-68. DOI:10.11876/mimt202205014.

[7]王正宇,孙宝平,苏文珍.智能化膝关节康复仪结合持续被动活动对胫骨平台骨折术后康复效果的影响[J].医学临床研究,2022,39(3):419-421. DOI:10.3969/j.issn.1671-7171.2022.03.027.

[8]Paget LDA, Sierevelt IN, Tol JL, et al. The completely patient-reported version of the American Orthopaedic Foot and Ankle Society (AOFAS) score: a valid and reliable measurement for ankle osteoarthritis[J]. J ISAKOS, 2023, 8(5):345-351. DOI: 10.1016/j.jisako.2023.07.003.

[9]Penning D, Kleipool S, van Dieren S, et al. The minimal clinically important difference (MCID) of the Olerud Molander Ankle Score (OMAS) in patients with unstable ankle fracture[J]. Arch Orthop Trauma Surg, 2023, 143(6):3103-3110. DOI: 10.1007/s00402-022-04533-y.

[10]孙红梅,项招妮,孙兆莲,等.AOFAS量化康复训练对踝关节骨折患者术后康复效果的影响[J].国际医药卫生导报,2023,29(22):3301-3305. DOI:10.3760/cma.j.issn.1007-1245.2023.22.036.

[11]刘玉波,张会增,张同润,等.踝关节骨折术后踝穴形态变化与踝关节功能的相关因素分析[J].中国组织工程研究,2022,26(3):440-445.

[12]何丽萍.推拿按摩联合活血止痛熏洗剂对踝关节骨折术后患者功能恢复及生活质量的影响[J].新中医,2020,52(10):124-127. DOI:10.13457/j.cnki.jncm.2020.10.036.

[13]杨捷,孙振辉,张弢,等.轨迹驱动式踝关节被动康复方案设计[J].机械科学与技术,2020,39(12):1828-1835. DOI:10.13433/j.cnki.1003-8728.20190349.

[14]韩康,刘媛媛,王甜甜,等.中医联合持续被动活动在踝关节骨折中的应用[J].长春中医药大学学报,2023,39(5):538-542. DOI:10.13463/j.cnki.cczyy.2023.05.016.

[15]范文,卢丛兰,陈芳,等.多学科整合护理路径在老年踝关节骨折治疗中的应用[J].实用医学杂志,2021,37(4):530-533. DOI:10.3969/j.issn.1006-5725.2021.04.022.

[16]毕菲,蔡振媛.关节持续被动活动机训练联合综合康复治疗在下肢骨折后膝关节活动功能障碍患者中的应用效果[J].中国医药导报,2022,19(3):79-82. DOI:10.20047/j.issn1673-7210.2022.03.018.

[17]程跃,王美福,徐文山,等.持续被动活动在股骨远端骨折术后的临床疗效[J].创伤外科杂志,2023,25(8):597-601,607. DOI:10.3969/j.issn.1009-4237.2023.08.007.

[18]王士冲,赵定亮,化龙昂,等.机械动力牵拉法结合递进式目标康复锻炼对旋前外旋型踝关节骨折术后功能恢复的影响[J].西部医学,2023,35(8):1142-1146,1157. DOI:10.3969/j.issn.1672-3511.2023.08.009.

[19]Chuang LL, Chuang YF, Ju YJ, et al. Effects of ankle continuous passive motion on soleus hypertonia in individuals with cerebral palsy: a case series[J]. Biomed J, 2022, 45(4):708-716. DOI: 10.1016/j.bj.2021.07.010.

[20]刘娟,任虹,张硕,等.CPM配合SPS康复干预对尺骨鹰嘴骨折术后患者康复效果及关节功能、活动度、患者满意度的影响[J].重庆医学,2022,51(1):113-118. DOI:10.3969/j.issn.1671-8348.2022.01.025.

[21]王少峰,黄巧燕.持续被动运动在桡骨远端骨折内固定术后康复中的效果评价[J].实用手外科杂志,2021,35(1):23-26,110. DOI:10.3969/j.issn.1671-2722.2021.01.007.