Ceroni Dimitri, Martin Xavier E, Farpour-Lambert Nathalie J, Delhumeau Cécile, Kaelin André
Unit of Pediatric Orthopedics, Department of Child and Adolescent, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
J Pediatr Orthop. 2010 Dec;30(8):807-12. doi: 10.1097/BPO.0b013e3181fa7969.
Deleterious effects of lower limb immobilization in adults have been well described and suggest that altered muscle strength was not fully recoverable after rehabilitation. In this study, we hypothesized that the same significant differences in strength and power performances between the injured and noninjured leg are foreseeable 18 months after a lower limb fracture in teenagers, and between injured adolescents and healthy controls.
The effects of cast immobilization on the strength and power performance were evaluated 18 months after a lower limb fracture in 39 injured teenagers who were paired with healthy controls. Strength and power performance were assessed during a single-leg vertical jump test using a force platform.
At 18 months, strength performance in injured teenagers was similar in both lower limbs. A significant difference was found between injured and noninjured legs for maximal muscular power measurement. However, the limb symmetry index was superior to 85% for maximal muscular power, which should be considered as normal. Limb asymmetries greater than 15% for muscular strength and power were more frequent in injured teenagers than in noninjured children and adolescents, but the difference was statistically significant only for the mean muscle power (P=0.0003).
These findings show that the recovery of muscular strength and power is foreseeable after a lower limb fracture in the pediatric population, even if a greater percentage of injured teenagers was found to have limb asymmetries greater than 15% for mean muscular power 18 months after trauma compared with the healthy controls.
Level III, case-control study.
成人下肢固定的有害影响已得到充分描述,表明康复后肌肉力量的改变无法完全恢复。在本研究中,我们假设青少年下肢骨折18个月后,受伤腿与未受伤腿之间在力量和功率表现上会出现同样显著的差异,并且在受伤青少年与健康对照组之间也会如此。
对39名受伤青少年在下肢骨折18个月后进行石膏固定对其力量和功率表现的影响评估,这些青少年与健康对照组配对。使用测力平台在单腿垂直跳跃测试中评估力量和功率表现。
在18个月时,受伤青少年双下肢的力量表现相似。在最大肌肉功率测量方面,受伤腿与未受伤腿之间存在显著差异。然而,最大肌肉功率的肢体对称指数优于85%,应被视为正常。受伤青少年肌肉力量和功率的肢体不对称大于15%的情况比未受伤儿童和青少年更常见,但差异仅在平均肌肉功率方面具有统计学意义(P = 0.0003)。
这些发现表明,儿科人群下肢骨折后肌肉力量和功率的恢复是可预见的,即使与健康对照组相比,发现更高比例的受伤青少年在创伤后18个月平均肌肉功率的肢体不对称大于15%。
III级,病例对照研究。