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回顾性队列研究:桡骨远端骨折切开复位内固定术后一周内主动活动范围。

A retrospective cohort investigation of active range of motion within one week of open reduction and internal fixation of distal radius fractures.

机构信息

Logan Hospital, Queensland Health, Logan City, Queensland, Australia.

出版信息

J Hand Ther. 2013 Jul-Sep;26(3):225-30; quiz 231. doi: 10.1016/j.jht.2013.05.002. Epub 2013 Jun 14.

Abstract

UNLABELLED

Distal radius fractures stabilized by open reduction internal fixation (ORIF) have become increasingly common. There is currently no consensus on the optimal time to commence range of motion (ROM) exercises post-ORIF. A retrospective cohort review was conducted over a five-year period to compare wrist and forearm range of motion outcomes and number of therapy sessions between patients who commenced active ROM exercises within the first seven days and from day eight onward following ORIF of distal radius fractures. One hundred and twenty-one patient cases were identified. Clinical data, active ROM at initial and discharge therapy assessments, fracture type, surgical approaches, and number of therapy sessions attended were recorded. One hundred and seven (88.4%) cases had complete datasets. The early active ROM group (n = 37) commenced ROM a mean (SD) of 4.27 (1.8) days post-ORIF. The comparator group (n = 70) commenced ROM exercises 24.3 (13.6) days post-ORIF. No significant differences were identified between groups in ROM at initial or discharge assessments, or therapy sessions attended. The results from this study indicate that patients who commenced active ROM exercises an average of 24 days after surgery achieved comparable ROM outcomes with similar number of therapy sessions to those who commenced ROM exercises within the first week.

LEVEL OF EVIDENCE

2B, retrospective cohort.

摘要

目的:桡骨远端骨折经切开复位内固定(ORIF)治疗后越来越常见。目前对于 ORIF 术后开始进行关节活动度(ROM)锻炼的最佳时间尚未达成共识。本研究回顾性分析了 5 年内的病例,以比较 ORIF 治疗桡骨远端骨折后 7 天内开始主动 ROM 锻炼与 8 天后开始主动 ROM 锻炼的患者的腕关节和前臂 ROM 结果和治疗次数。

方法:共纳入 121 例患者。记录临床资料、初始和出院治疗评估时的主动 ROM、骨折类型、手术入路和接受的治疗次数。107 例(88.4%)患者有完整的数据集。早期主动 ROM 组(n=37)在 ORIF 后平均(标准差)4.27(1.8)天开始 ROM 锻炼。对照组(n=70)在 ORIF 后 24.3(13.6)天开始 ROM 锻炼。两组在初始或出院评估时的 ROM 或接受的治疗次数均无显著差异。

结果:本研究结果表明,平均在手术后 24 天开始主动 ROM 锻炼的患者与在第一周内开始 ROM 锻炼的患者具有相似的 ROM 结果和相似的治疗次数。

结论:桡骨远端骨折 ORIF 治疗后 24 天开始主动 ROM 锻炼与 7 天内开始主动 ROM 锻炼具有相似的临床效果。

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