骨科康复一体化模式对外踝韧带修复术患者踝关节功能的效果研究

关键词：外踝韧带修复术  骨科康复一体化  踝关节功能

Keywords:ankle ligament repair  integrated orthopedic rehabilitation  ankle function

摘要：

      摘要 目的：探讨骨科康复一体化模式对外踝韧带修复术患者在术后24周内的疼痛、踝关节功能、运动水平的效果。 方法：回顾性分析2021年9月—2022年9月于解放军总医院第四医学中心行踝关节外侧韧带修复术患者81例，根据是否进行骨科康复一体化模式下康复治疗分为试验组（n=43）和对照组（n=38）。试验组采用骨科康复一体化模式下的外踝韧带修复围手术期康复临床路径进行治疗，共12周；对照组术后给予常规康复。比较两组在术后2周、术后12周、24周时的VAS评分、AOFAS踝-后足功能评分、FAAM-ADL评分、FAAM-S评分、Tegner评分。 结果：术后12周时，与对照组相比试验组的AOFAS踝-后足功能评分较高、VAS评分较低，具有显著性差异（P=0.043、P=0.033）。与对照组比较，在术后24周时试验组的AOFAS踝-后足功能评分、FAAM-ADL、Tegner评分较高（P=0.017、P=0.021、P=0.038），VAS评分较低（P=0.035），均具有显著性差异。 结论：对外踝韧带修复术患者进行骨科康复一体化模式下的治疗能更好地改善患者踝关节功能，提高生存质量和运动水平。

Abstract:

      Abstract Objective： To investigate the effect of an integrated orthopedic rehabilitation model on pain， ankle function and exercise level over 24 weeks after lateral ankle ligament repair. Method： A retrospective cohort of 81 patients after ankle ligament repair at the fourth medical center of Chinese PLA general hospital from September， 2021 to September， 2022 were selected. The patients were divided into an experimental cohort（n=43） and a control cohort（n=38） by whether the patient had received integrated orthopaedic rehabilitation （strictly follow clinical pathway of rehabilitation for postoperative ankle ligament repair patients） or conventional physician-guided rehabilitation. American orthopedic foot and ankle society score （AOFAS）、 visual analogue scale（VAS）、 foot and ankle ability measure-activities of daily living（FAAM-ADL）、 foot and ankle ability measure- sport（FAAM-S） and Tegner score were assessed at 2 weeks、 12 weeks、 24 weeks after surgery. Result： The AOFAS、VAS score was statistically higher in experimental cohort than in control cohort at 12 weeks after surgery（P=0.043、P=0.033）. The AOFAS、FAAM-ADL、Tegner score（P=0.017、P=0.021、P=0.038，respectively） was higher and VAS score（P=0.035）was lower in the experimental cohort than in control cohort at 24 weeks. Conclusion： Integrated orthopaedic rehabilitation can improve ankle function， exercise level and quality of life on patients after ankle ligament repair surgery compared with conventional rehabilitation.