跟骨骨折术后系统康复治疗的临床疗效观察

关键词：跟骨骨折  切开复位固定术  康复

Keywords:calcaneal fracture  open reduction and internal fixation  rehabilitation

摘要：

      摘要 目的：探讨系统康复治疗对跟骨骨折术后功能恢复的作用。 方法：选择能坚持来院康复治疗的跟骨骨折术后患者22例24足为康复组；不能在院接受康复治疗的术后患者24例为对照组，两组患者在平均年龄、骨折分型、手术方法方面无差异。康复组的康复治疗方案分为4个阶段：第一阶段（术后2d—2周）；第二阶段（术后2—6周）；第三阶段（术后6—12周）；第四阶段（术后12—16周）。康复治疗内容包括：消除肿胀，增加关节活动度训练，增强肌肉力量训练，本体感觉训练，步态训练。术后8周、14周进行评定，评定采用美国足与踝关节协会（AOFAS）踝与后足功能评分标准。 结果：康复组术后第8周在踝关节活动范围、足部疼痛方面显著优于对照组（P<0.05)；术后14周在疼痛、足部功能显著优于对照组（P<0.01）。 结论：系统康复治疗对跟骨骨折术后的功能恢复有显著疗效，可降低损伤造成的残疾。

Abstract:

      Abstract Objective:To investigate the effect of systematic rehabilitation for the patients after calcaneal fracture operation. Method: Twenty-two cases(24 feet),who could insist rehabilitation treatment in hospital were enrolled into rehabilitation group. Twenty-four cases who could not receive rehabilitation treatment in hospital were enrolled into control group. There was no difference between two groups in mean age,classfication of fracture and method of operation. The patients'treatment in rehabilitation group consisted of four stages: the 1st stage was the 2nd day—the 2nd week post operation.the 2nd stage was the 2nd—6th week, and the 3rd and 4th stage were the 6th—12th week and the 12th—16th week respectively. Rehabilitation protocol included swelling reduction,muscle strengthening,passive and active range of motion(ROM) exercises, proprioception exercises and gait training.The evaluation indexes involved America organization foot-ankle scale(AOFAS) and function of ankle and hindfoot. Patients were tested at the 8th week and the 14th week after operation. Result: At the 8th week after operation,ROM and pain of ankle and hindfoot in rehabilitation group were obviously better than that in control group(P<0.05). At the 14th week after operation, pain and function of ankle and hindfoot in rehabilitation group were also obviously better than that in control group(P<0.01). Conclusion: Systematic rehabilitation training for the patients after calcaneal fracture operation is effective for restoring the function of ankle and hindfoot,and it can relieve disability resulted from injury.