《中国康复理论与实践》

《中国康复理论与实践》 ›› 2010, Vol. 16 ›› Issue (11): 1010-1012.

• 论文 • 上一篇    下一篇

外伤后肘关节僵硬康复中优先恢复屈曲功能的意义

唐金树，石秀秀，吴闻文，吴金玲，李岩，侯树勋   

  1. 解放军总医院第一附属医院骨科，北京市 100048（1967-），男，浙江绍兴市人，博士，副主任医师，主要从事骨科及骨科康复工作。复应用关节松动手法训练，而伸直功能改由医生指导下的患者自行训练结合治疗师轻柔和短暂的牵伸训练。
  • 收稿日期:2010-09-21 修回日期:2010-09-27 出版日期:2010-11-25 发布日期:2010-11-25

Significance of Flexion Priority in the Rehabilitation of Posttraumatic Stiffness of Elbow

TANG Jin-shu， SHI Xiu-xiu，WU Wen-wen，et al   

  1. Department of Orthopedic Surgery， The First Affiliated Hospital of Chinese PLA General Hospital， Beijing 100048, China
  • Received:2010-09-21 Revised:2010-09-27 Published:2010-11-25 Online:2010-11-25

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摘要： 目的探讨外伤后肘关节僵硬康复中优先恢复屈曲功能的意义以及关节松动技术在肘关节康复中的应用原则。方法24例外伤或手术后肘关节屈伸功能障碍患者分成治疗组和对照组，每组12例。治疗组实施优先恢复屈曲功能的原则，将关节松动技术只用于屈曲功能的治疗，而伸直功能的恢复由医生指导下的自行训练结合治疗师轻柔的被动牵伸，以减轻关节松动技术伸直训练后引起的疼痛影响屈曲功能的尽快恢复。对照组常规应用关节松动技术每天各进行一次屈曲和伸直功能训练。治疗后6周测定关节屈曲度、伸直度和屈伸弧。结果治疗6周后，治疗组关节屈曲度为95°～135°（平均124°），明显优于对照组的80°～110°（平均95°）（P＜0.01）；伸直度10°～35°（平均15°），与对照组10°～30°（平均16°）无显著性差异（P＞0.05）；治疗组屈伸弧增加53°（从56°到109°），对照组屈伸弧增加30°（从51°到81°）（P＜0.01）。结论对肘关节外伤后同时存在屈曲和伸直功能障碍的患者，应优先恢复屈曲功能。

关键词: 关节松动技术, 肘关节僵硬, 屈曲优先

Abstract: ObjectiveTo evaluate the significance of flexion priority strategy and the principle of joint mobilization technique in the rehabilitation of posttraumatic stiffness of the elbow. Methods24 patients with posttraumatic stiffness of the elbow were divided into 2 groups, 12 patients in each group. The treatment group was treated with flexion priority strategy of joint mobilization technique only in the treatment of flexion contracture. In order to decrease the pain caused by joint mobilization training of extension and achieve the restoration of flexion as early as possible, the rehabilitation of extension was altered to self-exercise under the consultation of doctors combined with gentle passive traction by the therapist. The control group was treated with joint mobilization technique of both flexion and extension once a day. All the patients were measured the flexion range, extension range, and flexion-extension arc after 6 weeks of rehabilitation. Results6 weeks after rehabilitation, the treatment group got 124° of flexion (range 95°～135°), much better than the control group of 95° (range 80°～110°) （P<0.01）. There was no significant difference of extension degrees between the treatment group (15°, range 10°～35°) and the control group (16°, range 10°～30°) （P＞0.05）. The final arc of flexion and extension in the treatment group had an increase of 53°, significantly greater than 30° in the control group（P<0.01）. ConclusionFlexion priority strategy of elbow rehabilitation can significantly restore the flexion function of posttraumatic elbow stiffness.

Key words: joint mobilization technique, elbow stiffness, flexion priority