胫骨平台骨折术后辅助与不辅助持续被动运动的疗效比较

【】　目的　比较胫骨平台骨折术后辅助与不辅助持续被动运动（continuouspassivemotion，CPM）的临床疗效。　方法　对2008年6月-2009年6月86例行手术治疗的闭合性、无合并损伤的胫骨平台骨折患者进行回顾性分析。根据是否辅助CPM分为CPM组27例和非CPM组（对照组）59例。对两组患者的伤口愈合情况，膝关节屈曲、伸直角度，以及膝关节功能恢复情况进行比较。　结果　两组伤口甲级愈合率差异无统计学意义（P=0.566）。在术后2周和6周，CPM组患者的膝关节屈曲角度明显大于对照组（P<0.001），但在术后3个月和12个月，两组的差异无统计学意义（P=0.219，P=0.512）。在术后2、6周，3、12个月，CPM组和对照组患者的膝关节伸直角度差异无统计学意义。在术后12个月的Rasmussen膝关节功能评分方面，CPM组和对照组的差异无统计学意义。　结论　胫骨平台骨折术后辅助CPM能早期提升膝关节屈曲角度，但并不能提高远期的膝关节活动度和最终的膝关节功能。？【Abstract】　Objective　Tocomparethetherapeuticeffectofcontinuouspassivemotion(CPM)treatmentaftertibialplateaufracturesoperation.　Methods　FromJune2008toJune2009,86patientsweretreatedduetoclosedtibialplateaufractureswithoutcombinedinjuries.Thepatientsweretreatedwith(27patients,CPMgroup)andwithout(59patients,controlgroup)CPM.Thewoundhealingrates,rangeofmotionandthekneefunctionwerecomparedbetweenthetwogroups.　Results　Therewasnosignificantdifferencebetweenthetwogroupsinwoundhealingrates(P=0.566).Twoandsixweeksaftertheoperation,thereweresignificantdifferencesbetweenthetwogroupsinflexiondegree(P<0.001);threeand12monthsaftertheoperation,therewerenosignificantdifferencesbetweenthetwogroups(P=0.219,P=0.512).Atthe2ndand6thweek,3rdand12thmonthpostoperatively,therewerenosignificantdifferencesbetweenthegroupsinextensiondegree.Twelvemonthsaftertheoperation,therewerenosignificantdifferencesbetweenthegroupsinfunctionalrecoveryoftheknee.　Conclusion　CPMinthepost-operativetreatmentoftibialplateaufracturesiseffectiveincreasingkneeflexionintheearlystage,butisnoteffectiveincreasingrangeofmotionorkneefunctioninalongterm.