【摘要】 目的：探讨膝关节手术后最佳的功能锻炼时机。方法：选用C1型股骨远端骨折，胫骨近端骨折和髌骨骨折，按术后功能锻炼时间分为3组，统计术后30 d的膝关节功能。结果：麻醉消退后即刻开始功能锻炼组术后30 d的膝关节功能优良，较B、C组有统计学差异。结论：在膝关节周围骨折手术坚强固定的基础上，麻醉消退后即刻开始功能锻炼，确能较术后24 h和72 h才开始锻炼,在减轻膝关节的粘连，减少关节内瘢痕组织增生，最大限度地恢复膝关节的功能等方面有着明显的优点。
【关键词】 膝关节;外科手术;功能恢复
Relation of clinical effect to postoperative functional exercise time in knee joint operation
LI Changju, ZHANG Huixuan, YANG Chunguo
(Department of Orthopedics, Dongkeng People s Hospital of Dongguan City, Guangdong Province, Dongguan 523451,China)
[ABSTRACT] Objective: To explore the optimal time of postoperative functional exercise of knee joint operation. Methods: Patients with distal femoral type C1 fractures, proximal tibial fractures and patellar fracture were divided into 3 groups by the initial time of postoperative functional exercise; the knee joints functions were observed 30 days after the operation. Results: The functions of knee joints were satisfactory in patients who started functional exercise immediately after recovery from anesthesia; compared with patients in other groups whose initial functional exercise time was later, there were significant differences. Conclusion: On the condition of the fractures being well fixed, patients who start functional exercise immediately after recovery from anesthesia are better for functional recovery than those who do it in 24 h and 72 h after operation, has less joint adhesion and less proliferation of scars.
[KEY WORDS] Knee joints; Surgical procedures, operative; Functional recovery
膝关节周围骨折是创伤骨科常见的疾病，在坚强固定的基础上，早期开始功能锻炼已成为大家的共识，但对早期的确切时间却没有一个公认的标准。是术后麻醉消失即刻，还是术后24 h，抑或术后72 h?通过分析自2000年1月～2007年5月治疗的膝关节周围骨折的100余例患者，为统计的科学性，选取其中60例做为临床观察对象，试图寻找一个膝关节手术后最佳的功能锻炼时机。
1 资料与方法
1.1 一般资料
本组60例，男42例，女18例，年龄18～58岁，平均38.9岁。按AO分类:股骨远端骨折C1型18例，胫骨近端骨折C1型18例，髌骨骨折C1型24例。
1.2 治疗方法
股骨远端骨折C1型采用GSH钉固定，胫骨近端骨折C1型采用高尔夫钢板固定，髌骨骨折C1型采用张力带固定。术后均不做外固定。术后主、被动功能锻炼时间分为3组，分别为A：术
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