目的:探讨股骨干骨折内固定术后膝关节功能与膝部疼痛的相关性.方法:回顾性分析2006年6月至2009年12月73例股骨干骨折内固定患者术后的临床资料.根据术后膝部疼痛程度分为高分组与低分组.其中,低分组39例,VAS评分1～5分,男25例,女14例.年龄27～63岁,平均(37.5±5.3)岁;高分组34例,VAS评分6～10分,男22例,女12例,年龄29～62岁,平均(36.3±9.6)岁.记录2组患者的术后膝内压和末次随访时的HSS评分,并进行分析比较.结果:所有患者获得随访,平均随访时间24.1个月.术后3d,高分组膝内压高于低分组(t=15.67,P=0.000);随访终末期,高分组膝内压仍高于低分组(t=5.63,P=0.000 ).膝关节功能:高分组优21例,良4例,一般7例,差2例;低分组优31例,良6例,一般2例,差0例.低分组膝关节功能优于高分组.结论:膝内压是影响术后膝关节功能恢复的重要因素,而其外在症状疼痛程度可作为早期判断膝关节功能预后的重要指标之一.%Objective:To investigate the relationship between pain and knee function after the internal fixation of femoral fractures. Methods:The clinical data of 73 patients after internal fixation on femoral fractures from June 2006 to December 2009 were retrospectively analyzed. All the patients were divided into two groups according to the degree of postoperative pain: low score group and high score group. Among the 39 patients in low score group (VAS 1 to 5 point) ,25 patients were male and 14 patients were female,with a mean age of (37.5±5.3) years (ranged from 27 to 63 years ). Among 34 patients in high score group (VAS 6 to 10 point) ,22 patients were male and 12 patients were female,with a mean age of (36.3±9.6) years(ranged from 29 to 62 years). The intra-articular pressure of knee and hospital for special surgery knee rating scale (HSS) were recorded and analyzed. Results: All the patients were followed up for an average duration of 24.1 months. The intra-articular pressure of knee was rising for two groups, there were significant difference for the high score group compared with the low score group at 3 days after operation (t= 15.67 ,P=0.000) and the end time of follow up (t=5.63 ,P=0.000). As to knee joint function, in low score group,21 patients got an excellent result,4 good,7 poor and 2 bad;in high score group,31 patients got an excellent result , 6 good, 2 poor and no bad. The knee function of low score group was better than that of high score group. Conclusion: The intra-articular pressure of knee is an important factor of the knee functional recovery, and its external symptoms of pain can be seen as an important index to forecast the prognosins of knee function in early time.
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