运动疗法对髌骨骨折康复作用的研究进展

Research Progress in the Rehabilitation Effect of Exercise Therapy on Patellar Fracture

摘要: 髌骨骨折多是由直接或者间接暴力所致，大约占全身损伤骨折的5%~10%。作为最大籽骨的髌骨，是膝关节的重要组成部分，可加强膝关节活动最后的10˚~15˚的背伸作用，增强股四头肌肌腱对小腿的拉力作用。其骨折常会造成关节伸膝装置功能连续性丧失及隐性的膝关节功能失调，严重者可导致功能永久性不全及致残。目前临床上对髌骨骨折治疗的方法多种多样，早期行切开复位内固定手术已成为国内外专家共识，作为最佳的治疗方式，除不能复位的粉碎性骨折外，应尽可能的保留髌骨，髌骨在膝关节中起到至关重要的作用。术后患者经常会因疼痛或心理因素而被迫制动，最后引起相关肌肉萎缩及关节功能损伤，对患者的正常生产生活造成困扰，加重经济压力及心理负担，严重降低日常生活质量。术后并发症是外科手术无法避免的情况，术后常见的并发症有创伤性关节炎、骨化性肌炎、髌骨二次骨折、骨折术后的延迟愈合及骨不愈合等。所以术后的康复治疗至关重要，而选择康复的时机和具体康复过程是近年来临床医务工作者及学者关注的焦点。

Abstract: Patella fracture is mostly caused by direct or indirect violence, accounting for about 5%~10% of to-tal body injury fractures. As the largest sesamoid bone, the patella is an important part of the knee joint, which can strengthen the dorsiextension effect of the last 10˚~15˚ of the knee joint activity, and enhance the pull effect of the quadriceps tendon on the calf. The fracture often results in con-tinuous loss of function of joint extensor device and hidden knee dysfunction, and in severe cases, permanent dysfunction and disability. At present, there are a variety of clinical treatment methods for patella fracture, and early open reduction and internal fixation has become the consensus of ex-perts at home and abroad. As the best treatment method, patella should be preserved as much as possible, except for combitable fractures that cannot be reduced. Patella plays a crucial role in the knee joint. Postoperative patients will often be forced to brake due to pain or psychological control, and finally cause related muscle atrophy and joint function injury, causing trouble to the normal production and life of patients, increasing economic pressure and psychological burden, and seri-ously reducing the quality of daily life. Postoperative complications are unavoidable in surgery. Common postoperative complications include traumatic arthritis, myositis ossificans, secondary fracture of patella, delayed union and bone nonunion after fracture. Therefore, postoperative reha-bilitation is very important, and the selection of the timing and specific rehabilitation process is the focus of clinical medical workers and scholars in recent years.