机器人辅助老年股骨粗隆间骨折内固定术后康复△

Robot-assisted rehabilitation after internal fixation of intertrochanteric femoral fractures in elderly

摘要:

[目的]探讨下肢康复机器人辅助训练对老年股骨粗隆间骨折内固定术后下肢功能恢复的临床效果。[方法]回顾性分析 2021 年 1 月—2022 年 12 月行股骨近端髓内钉固定治疗的 86 例股骨粗隆间骨折患者的临床资料，根据医患沟通结果，43 例给予下肢康复机器人辅助训练（机器人组），另外 43 例给予传统康复训练（常规组）。评价患者康复后临床疗效及并发症发生情况。[结果]两组患者手术时间、术中失血量的差异均无统计学意义（P＞0.05）。患者均顺利完成康复及随访。与术后 1 d 相比，术后 12 周两组 VAS 评分均显著减少 （P＜0.05）。术后 12 周机器人组的 VAS [(2.3±0.8) vs (2.7±0.7), P=0.016]、Harris [(88.6± 9.0) vs (76.3±8.1), P＜0.001]、BBS [(48.6±8.0) vs (39.3±6.1), P＜0.001] 及 MBI 评分 [(69.7±12.2) vs (58.1±11.0), P＜0.001] 均显著优于常规组；此外，术后 12 周机器人组的步长 [(37.2±4.9) cm vs (34.6±4.4) cm, P=0.011]、步速 [(36.7±3.2) m/min vs (32.2±3.2) m/min, P＜ 0.001] 和步宽 [(11.1±1.) cm vs (9.7±1.3) cm, P＜0.001] 均显著优于常规组。[结论]老年股骨粗隆间骨折内固定术后辅助下肢康复机器人训练可以改善患者的髋关节功能，提高运动能力和生活质量，减少并发症。

Abstract:

[Objective] To investigate the clinical outcome of robot-assisted rehabilitation after internal fixation of intertrochanteric femoral fractures in elderly. [Methods] A retrospective study was done on 86 patients who had femoral intertrochanteric fracture treated with proximal femoral intramedullary nail from January 2021 to December 2022. According to doctor- patient communication, 43 patients received the robot-assisted rehabilitation training (the robot group), while other 43 patients received traditional rehabilitation training (routine group). Clinical consequence and complications were evaluated. [Results] There were no significant differences in operation time and intraoperative blood loss between the two groups (P＞0.05). All patients successfully completed rehabilitation and followup. Compared with 1 day after surgery, VAS scores in both groups were significantly decreased at 12 weeks after surgery (P＜0.05). The robot group proved significantly superior to the routine group in terms of VAS [(2.3±0.8) vs (2.7±0.7), P=0.016], Harris [(88.6±9.0) vs (76.3±8.1), P＜0.001], BBS [(48.6±8.0) vs (39.3±6.1), P＜0.001] and MBI scores [(69.7±12.2) vs (58.1±11.0), P＜0.001] 12 weeks after operation. In addition, the former was also significantly better than the latter in terms of step length [(37.2±4.9) cm vs (34.6±4.4) cm, P=0.011], step speed [(36.7±3.2) m/min vs (32.2±3.2) m/min, P＜0.001] and step width [(11.1±1.) cm vs (9.7±1.3) cm, P＜0.001] 12 weeks postoperatively. [Conclusion] Robot assisted rehabilitation after internal fixation of femoral intertrochanteric fractures in elderly does improve hip function, improve movement ability and quality of life, and reduce complications.