目的:探讨闭合复位弹性髓内钉固定术(CR-ESIN)对股骨骨折患儿康复进程及关节功能的影响。方法:回顾性选取2024年4月~2025年6月至我院行内固定术治疗的102例股骨骨折患儿为研究对象,依据手术方案不同,将行CR-ESIN治疗的51例患儿列为CR-ESIN组,将剩余51例行传统切开复位接骨板内固定术(ORIF)治疗的患儿列为ORIF组,比较两组患儿的治疗情况、康复进程,手术并发症发生情况,关节功能恢复情况及内固定物取出阶段负担。结果:在不同手术方案下,CR-ESIN组的手术耗时、术中出血量、术后住院时间、支具使用时间、完全负重时间分别为(60.29±5.44)min、(50.52±5.49)mL、(6.22±1.34)d、(4.15±1.33)周、(6.81±1.34)周,均低于ORIF组[(76.33±8.29)min、(190.48±20.51)mL、(8.17±1.65)d、(6.32±1.48)周、(7.82±2.17)周](t=11.552,47.076,6.552,8.322,2.828;P<0.05)。CR-ESIN组的手术并发症发生率5.88%(3/51)低于ORIF组19.61%(10/51)(x2=4.320;P<0.05)。CR-ESIN组的髋关节前屈活动度、后伸活动度、儿童下肢功能量表(PODCI)评分分别为(132.44±22.52)°、(20.39±4.47)°、(75.14±6.29)分,均高于ORIF组[(120.28±20.37)°、(17.55±3.12)°、(70.31±5.36)分],术后双侧股骨长度差(1.52±0.39)cm低于ORIF组(3.08±0.44)cm(t=2.860,3.721,4.174,18.948;P<0.05)。CR-ESIN组的取出手术切口长度、取出手术耗时、取出手术出血量、再骨折率均低于ORIF组(t/x2=31.706,8.298,38.448,4.883;P<0.05)。结论:CR-ESIN能提高股骨骨折患儿手术效率并降低出血风险,与传统ORIF相比,此术式有利于加快患儿康复进程、降低术后并发症发生率、促进关节功能恢复并减轻内固定物取出阶段负担。
Objective:To explore the effects of closed reduction elastic intramedullary nail fixation (CR-ESIN) on the rehabilitation process and joint function of children with femoral fractures.Methods:A retrospective study was conducted on 102 children with femoral fractures who underwent internal fixation surgery in our hospital from April 2024 to June 2025. Based on different surgical plans, 51 children who underwent CR-ESIN treatment were included in the CR-ESIN group, and the remaining 51 children who underwent traditional open reduction plate internal fixation (ORIF) treatment were included in the ORIF group. The treatment status, rehabilitation process, incidence of surgical complications, joint function recovery, and burden during the removal of internal fixation materials were compared between the two groups of children.Results:Under different surgical plans, the surgical time, intraoperative blood loss, postoperative hospitalization time, brace use time, and complete weight-bearing time of the CR-ESIN group were (60.29 ± 5.44) min, (50.52 ± 5.49) mL, (6.22 ± 1.34) d, (4.15 ± 1.33) weeks, and (6.81 ± 1.34) weeks, lower than the ORIF group [(76.33 ± 8.29) min, (190.48 ± 20.51) mL, (8.17 ± 1.65) d, (6.32 ± 1.48) weeks, and (7.82 ± 2.17) weeks] (t=11.552,47.076,6.552,8.322,2.828; P<0.05). The incidence of surgical complications in the CR-ESIN group was 5.88% (3/51) lower than the ORIF group 19.61% (10/51) (x2=4.320; P<0.05). The hip flexion range of motion, extension range of motion, and PODCI scores of the CR-ESIN group were (132.44 ± 22.52) °, (20.39 ± 4.47) °, and (75.14 ± 6.29) points, higher than the ORIF group [(120.28 ± 20.37) °, (17.55 ± 3.12) °, and (70.31 ± 5.36) points]. The length difference between the bilateral femurs was (1.52 ± 0.39) cm, which was lower than the ORIF group (3.08 ± 0.44) cm (t=2.860,3.721,4.174,18.948; P<0.05). The length of the surgical incision, the duration of the extraction surgery, the amount of bleeding during the extraction surgery, and the rate of re fracture in the CR-ESIN group were all lower than the ORIF group (t/x2=31.706,8.298,38.448,4.883; P<0.05).Conclusion:CR-ESIN can improve the surgical efficiency and reduce the risk of bleeding in children with femoral fractures. Compared with traditional ORIF, this procedure is beneficial for accelerating the recovery process of children, reducing the incidence of postoperative complications, promoting joint function recovery, and reducing the burden of internal fixation removal stage.
论著
目的 探讨富血小板血浆(PRP)联合关节镜治疗Ⅲ度半月板损伤患者的临床疗效,及其对膝关节功能恢复时间的影响。方法 选取2021年2月—2022年2月南方医科大学南方医院增城院区骨科收治的Ⅲ度半月板损伤患者45例,采用随机数字法分为观察组22例与对照组23例,对照组患者在关节镜下行半月板成形术,观察组在对照组基础上给予PRP治疗。观察两组患者术后恢复时间、治疗效果及并发症发生情况;比较两组治疗前和治疗后1、3、6个月膝关节功能、疼痛情况。结果 利用观察组患者自体全血制备的PRP,其血小板的回收率、红细胞留存率、白细胞留存率分别为(91.00±9.27)%、(0.29±0.12)%、(29.98±6.68)%,PRP制备质量稳定、可控。观察组联合PRP治疗术与关节镜手术治疗后恢复时间均短于对照组,观察组治疗有效率高于对照组(P<0.05)。经重复方差测量分析,两组美国特种外科医院膝关节评分系统(HSS)评分、西安大略大学和麦克马斯特大学骨关节炎指数(WOMAC)评分、视觉模拟疼痛评分法(VAS)交互(F交互=1.869、F交互=1.482、F交互=2.193)比较差异均有统计学意义(P<0.05);与对照组治疗后1、3、6个月比较,观察组HSS评分升高,WOMAC评分、VAS评分下降(P<0.05);观察组并发症总发生率4.55%低于对照组30.43%(χ2=5.156、P=0.023)。结论 对于Ⅲ度半月板损伤患者,采用PRP联合关节镜手术治疗可帮助患者消炎止痛、加快疗效、加快膝关节功能的恢复,缩短其恢复的时间,效果良好,且安全性较高。
Objective To investigate the clinical effect of platelet rich plasma(PRP)combined with arthroscopy treatment on patients with third degree meniscus injury,and its impact on the recovery time of knee joint function.Methods From February 2021 to February 2022,45 patients with III-degree meniscal injuries admitted to the Department of Orthopedics,Zengcheng district,Nanfang Hospital of Southern Medical University were selected and divided into an observation group of 22 cases and a control group of 23 cases using the random number method.Patients in the control group received menisplasty under arthroscopy,and the observation group was given PRP treatment on the basis of the control group.The postoperative recovery time,treatment effects and complications of the two groups of patients were observed;the knee joint function and pain of the two groups before treatment and 1,3,and 6 months after treatment were compared.Results The platelet recovery rate,red blood cell retention rate,and white blood cell retention rate of PRP prepared from the autologous whole blood of patients in the observation group were(91.00±9.27)%,(0.29±0.12)%,and(29.98±6.68)% respectively.The PRP preparation quality is stable and controllable.The recovery time after combined PRP treatment and arthroscopic surgery in the observation group was shorter than that in the control group,and the treatment effectiveness of the observation group was higher than that of the control group(P<0.05).After repeated measures of variance analysis,the comparison of American Hospital for Special Surgery(HSS)Knee Scoring System,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),and visual analogue pain scales(VAS)interacted(FInteraction=1.869,Finteraction=1.482,Finteraction=2.193),the differences were statistically significant(P<0.05).Compared with the control group 1,3,and 6 months after treatment,the HSS score of the observation group increased,and the WOMAC score,VAS score decreased(P<0.05);the total incidence of complications in the observation group was 4.55%,lower than that in the control group(30.43%,χ2=5.156,P=0.023).Conclusions For patients with III-degree meniscal injuries,PRP combined with arthroscopic surgery can help reduce inflammation and pain,speed up the curative effect,accelerate the recovery of knee joint function,and shorten the recovery time.It has good effects and is relatively safe.
论著
目的 探讨本体感觉训练联合等速肌力训练对早期膝骨关节炎(KOA)患者的应用效果。方法 选择郑州市骨科医院2022年5月—2023年5月收治的120例早期膝骨关节炎患者为研究对象,将所有对象进行编号,采用简单随机方法分成研究组和对照组,每组各60例,两组均接受常规治疗,对照组在此基础上接受等速肌力训练,研究组在对照组基础上联合应用本体感觉训练,比较两组治疗前和治疗6周后疼痛视觉模拟量表(VAS)评分、膝关节伸屈肌群峰力矩(PT)、关节功能以及本体感觉。结果 治疗后研究组VAS评分为(1.33±0.31)分,对照组为(2.05±0.34)分,研究组低于对照组(t=12.121,P<0.05);治疗后两组膝关节伸、屈肌群PT均较治疗前明显增加(P<0.05),研究组大于对照组(t1=2.696,t2=3.360,P<0.05);治疗后研究组WOMAC评分为(24.58±5.14)分,对照组为(26.85±5.11)分,研究组低于对照组(t=2.426,P<0.001),研究组Lequesne指数为(6.55±1.21)分,对照组为(7.02±1.25)分,研究组低于对照组(t=2.093,P<0.001);治疗后研究组平均轨迹误差为(21.35±5.96)%,对照组为(24.06±5.88)%,研究组改善程度优于对照组(t=2.507,P<0.001),研究组平均负重力量差为(0.77±0.22)kg,对照组为(1.01±0.24)kg,研究组改善程度明显优于对照组(t=5.710,P<0.001)。结论 本体感觉训练联合等速肌力训练可以显著提升早期膝骨关节炎患者肌力,改善关节功能和本体感觉作用明显,适合推广。
Objective To explore the application effect of proprioceptive training combined with isokinetic muscle strength training on early knee osteoarthritis(KOA)patients.Methods A total of 120 patients with early knee osteoarthritis admitted to a hospital from May 2022 to May 2023 were selected as the study subjects.All subjects were numbered and randomly divided into an experimental group and a control group,with 60 cases in each group.Both groups received routine treatment,while the control group received isokinetic muscle strength training additionally.The experimental group received proprioceptive training in addition to the control group treatment.After 6 weeks of treatment,compare the pain situation,peak torque(PT)of knee extensor and flexor muscles,joint function,and proprioception before and after treatment between two groups were compared.Results After treatment,the VAS scores of both groups were lower than those before treatment(P<0.05),and the experimental group was lower than the control group(t=12.121,P<0.05).After treatment,the PT of the knee joint extensor and flexor muscle groups in both groups significantly increased compared to before treatment(P<0.05),and the experimental group was significantly larger than the control group(P<0.05).After treatment,the WOMAC score and Lequesne index of the two groups significantly decreased compared to those before treatment(P<0.05),and the experimental group was smaller than the control group(P<0.05).After treatment,the average trajectory error and average weight difference between the two groups were significantly smaller than those before treatment(P<0.05),while the experimental group was smaller than the control group(P<0.05).Conclusion sThe combination of proprioceptive training and isokinetic muscle strength training can significantly improve muscle strength,joint function,and proprioceptive sensation in patients with early knee osteoarthritis,making it suitable for promotion.
论著
目的 探讨功能康复训练与心理干预对全髋关节置换手术患者髋关节功能康复的影响。方法 对2014年3月—2015年12月先后在本院行全髋关节置换手术90例患者,按入院时间分为观察组45例和对照组45例。对照组按全髋关节置换手术功能康复护理要求给予康复护理;观察组在此功能康复护理基础上,同时对患者进行心理评估和相应的心理护理干预;对两组患者在干预前后的心理情况、生活自理能力、髋关节功能和生活质量进行评价。结果 干预前两组患者均有不同程度的焦虑和抑郁反应,不积极的应对方式和自理能力下降;干预后观察组在应对心理反应,降低焦虑和抑郁,主动进行功能锻炼,自理能力和髋关节功能评分均优于对照组。结论 功能康复训练与心理护理干预相结合,对减轻患者心理压力,提高患者心理应对能力、生活自理能力,提高患者生活质量,促进髋关节功能康复有一定的效果。
Objectives To explore the effect of function rehabilitation training and psychological intervention on patients of hip joint function recovery undergoing THA. Methods 90 patients were chosen who were admitted to the hospital from March 2014 to December undergoing THA,2015. These patients were divided into control group and intervention group according to the sequence of admission. The patients in control group were cared by total hip replacement surgery functional rehabilitation; At the same time, the patients in observation group were cared by psychological training. The psychological condition, self-care ability, hip function and quality of life for all patients were evaluated. Results Before the intervention, two groups of patients had some degrees of anxiety and depression, and negative coping style. Their self-care ability were decreased; The response to psychological reaction, reduction for anxiety and depression, initiative exercise, self-care ability and hip function scores of patients in the intervention group were better than that of the control group. Conclusion Combination of rehabilitation training and psychological nursing intervention can relieve the psychological pressure, improve mental health and promote recovery of hip function.