目的 探讨肱骨远端C型骨折术后不同时期及不同制动体位功能锻炼对肘关节功能康复的影响.方法 2013年6月至2015年7月肱骨远端C型骨折患者80例,分为A、B两组各40例,A组术后立即开始功能锻炼;B组术后石膏外固定于肘关节功能位(即屈肘90°位)制动1周后开始功能锻炼.分别在术后2周及6个月观察患者的肘关节疼痛及活动度.结果 术后2周A组Mayo肘关节功能评分及肘关节屈伸活动度优于B组,VAS评分低于B组(P<0.05),两组前臂旋转活动度差异无统计学意义(P>0.05);术后6个月A组肘关节屈伸活动度优于B组(P<0.05),两组Mayo肘关节功能评分、VAS评分及前臂旋转活动度差异无统计学意义(P>0.05).结论 对于肱骨远端C型骨折患者,术后立即肘关节功能锻炼较延迟功能锻炼在术后早期(2周),可以减轻患者疼痛,促进肘关节屈伸功能恢复,在术后长期随访(术后6月),可获得较好的肘关节伸屈功能活动范围.
Objective To investigate the effect of functional rehabilitation at different stages and different immobilization positions after C type fracture of distal humerus on functional recovery of elbow joint.Methods Eighty patients with type C fracture of the distal humerus from June 2013 to July 2015 were divided into A and B groups,40 in each group.In the A group,functional exercise was immediately started after operation while in the B group,functional exercise was started after plaster external fixation being performed at the elbow joint function position (i.e.elbow 90 degrees) and braked for one week.The pain and mobility of the elbow joint were observed in the 2 nd and 6 th month after operation,respectively.Results After 2 weeks of operation,in the A group,Mayo elbow function score and elbow flexion and extension were better and VAS score was lower when compared to the B group (P < 0.05).No statistically significant difference in forearm rotation activity was observed between the two groups (P > 0.05).After 6 months of surgery,elbow joint flexion and extension in the A group was better than those in the B group (P < 0.05) but differences in Mayo score,VAS score and forearm rotation activity were not significant between the two groups (P > 0.05).Conclusion For patients with type C fracture of distal humerus,the immediate postoperative functional exercise can reduce the pain of patients and promote the elbow joint function recovery at early stage (2 weeks) after operation.Further,this can obtain better elbow flexion range during long-term follow-up after operation (6 months).