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骨盆环骨折患者的术后步态分析及髋关节肌力。

Postoperative gait analysis and hip muscle strength in patients with pelvic ring fracture.

机构信息

Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui 910-1193, Japan.

出版信息

Gait Posture. 2013 Jul;38(3):385-90. doi: 10.1016/j.gaitpost.2012.12.016. Epub 2013 Jan 18.

Abstract

The aims of present study were (1) to determine changes in kinematic and kinetic variables at 3 and 12 months after open reduction and internal fixation (ORIF) of pelvic ring fracture and (2) to determine the factor(s) associated with gait disorders that correlate with gait parameters measured at 12 months after surgery. Nineteen patients with pelvic ring fractures underwent ORIF and examined at 3 and 12 months postoperatively. The study also included a similar number of age-matched control subjects. Peak hip abduction angle, peak hip extension moment in the stance, peak hip abduction moment, and peak ankle plantarflexion moment at 3 months after ORIF were significantly lower than the respective control values. At 12 months, complete recovery was noted in peak hip abduction moment and peak ankle plantarflexion moment, whereas the recovery in peak hip abduction angle and peak hip extension moment in the stance was partial. The existence of neurological lesions and strength asymmetry of hip abductor and adductor at 3 months post-ORIF correlated with decreased peak hip abduction moment after ORIF. Our results highlighted characteristic gait patterns up to 12 months after ORIF for pelvic fracture, and these patterns correlated with neurological lesion and weakness of hip abductor and adductor muscles.

摘要

本研究的目的是

(1) 确定骨盆环骨折切开复位内固定(ORIF)后 3 个月和 12 个月时运动学和动力学变量的变化;(2) 确定与术后 12 个月测量的步态参数相关的、与步态障碍相关的因素。19 例骨盆环骨折患者接受 ORIF 治疗,并在术后 3 个月和 12 个月进行检查。该研究还包括了数量相同的年龄匹配的对照组。与对照组相比,ORIF 后 3 个月时的髋关节外展峰值角度、站立时髋关节伸展峰值力矩、髋关节外展峰值力矩和踝关节跖屈峰值力矩明显较低。在 12 个月时,髋关节外展峰值力矩和踝关节跖屈峰值力矩完全恢复,而站立时髋关节外展峰值角度和髋关节伸展峰值力矩的恢复是部分的。ORIF 后 3 个月时存在神经病变和髋关节外展肌和内收肌力量不对称与 ORIF 后髋关节外展峰值力矩降低有关。我们的研究结果强调了骨盆骨折后 12 个月内的典型步态模式,这些模式与神经病变和髋关节外展肌和内收肌的无力有关。

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