【摘要】 目的回顾用股骨髁上逆向交锁髓内钉治疗骨质疏松性股骨远端骨折后功能锻炼的方法与效果。方法应用股骨髁上逆向交锁髓内钉治疗19例患者,均为平地跌倒。新鲜骨折18例(开放骨折3例),女性55岁以上12例,男性65岁以上7例,BMDt值在-2.5s以下。按AO分类为:A型2例,B型1例,C型16例。骨折均用股骨髁上逆行交锁髓内钉固定。陈旧性骨折合并膝关节僵硬者同时行膝关节粘连松解。术后患者经CybexII+机辅助的关节功能牵引和等速训练。结果19例正规功能锻炼患者随访6个月以上,骨折愈合时间平均6个月(3～12个月)。按Kolmert功能评定标准,优良16例(84.2%),一般2例(10.5%),差1例(5.3%)。结论股骨髁上逆行交锁髓内钉操作简便、固定牢靠、锁钉定位准确,术后早期正规的功能锻炼辅以药物治疗,对骨质疏松性骨折患肢功能恢复、提高生活质量有显著意义。更多还原

【Abstract】 Objective Reviewing the methods and results of the physical therapy after intramedullary nailing upon osteoporotic fracture in distal femur.Methods 19 patients who were all caused by falling were treated.There were 18 fresh fracture with 3 opened fracture.Female older than 55 and male older than 65 were chosen.They all had a BMD lower than-2.5 SD.The fractures were 2 type A,1 type B and 16 type C according to AO classification.There was one case of old fracture.We use retrograde intramedullary nail in these fragile fractures.Quadriceplasty were performed when the stiffness of the knees.19 patients received physical training aided by Cybex II.Results 19 patients were followed more than 6 months.Bone union had been reached in 6 months(3～12months).We got 16 good,2 fair and 1 bad according to Kolmert standard.Conclusions Physical therapy after intramedullary nailing upon distal femoral for osteoporosis are benefit to improve the life quality of the patients.更多还原