探讨骨科康复一体化模式对踝关节骨折中快速康复中的应用疗效。

纳入2021年1月至2022年10月在南通大学第六附属医院就诊的83例踝关节骨折患者，排除合并肢体其他部位骨折或韧带损伤、踝关节畸形、陈旧性骨折、开放性骨折、心脑血管病患者及神经系统病变者，以随机数字表法分为一体化治疗组(n＝41)和常规治疗组(n＝42)。比较两组术前等待天数，住院天数，术前1 d、术后2 d、术后3 d踝关节围度，术前1 d、术后1 d和3 d疼痛视觉模拟评分(VAS)，术后1周、1个月、3个月踝关节(Baird-Jackson)评分及术后并发症发生率。采用独立样本t检验、重复测量方差分析、秩和检验、卡方检验进行统计学分析。

一体化治疗组的术前等待天数及住院天数均短于常规治疗组(t＝11.977、17.653，均为P<0.05)。术前1 d、术后2 、3 d两组患者踝围重复测量方差分析中时间、组间及交互效应均具有统计学意义(时间：F＝681.232，组间：F＝372.328，交互：F＝9.894，均为P<0.05)。术前1 d、术后1、3 d两组患者VAS评分重复测量方差分析中时间、组间效应均具有统计学意义(时间：F ＝223.310，组间：F＝17.532，均为P<0.05)。术后1周、1个月、3个月一体化治疗组的Baird-Jackson评分均高于常规治疗组(Z＝－3.526、－5.627、－7.200，均为P<0.05)；一体化治疗组并发症发生率低于常规治疗组，但差异无统计学意义(χ²＝2.708，P>0.05)。

骨科康复一体化模式能够明显减少术前踝关节肿胀程度，控制术后疼痛，缩短手术前等待的时间及平均住院日，提高踝关节功能的质量，优化了踝关节骨折术后快速康复路径。

To explore the effect of the integrated orthopedic rehabilitation pathway in rapid rehabilitation of ankle fracture.

From January 2021 to October 2022, 83 patients with ankle fracture in the orthopedic department of Affiliated Hospital 6 of Nantong University were enrolled. Exclusion criteria: other limb fractures or ligament injuries, ankle joint deformities, old fractures, open fractures, cardiovascular and cerebrovascular diseases, and nervous system diseases. The patients were divided into integrated treatment group (n=41) and conventional treatment group (n=42) by random number table method. The waiting days before operation, hospitalization days, ankle circumference one day before surgery, two and three days after surgery, the visual analogue scale (VAS) of pain one day before operation, one day and three days after operation, the Baird-Jackson scores of ankle joint one week, one and three months after operation, and the postoperative complications rate between the two groups were compared. Independent t test, repeated measures ANOVA, rank-sum test, and chi square test were performed for data analysis.

The preoperative waiting days and hospitalization days in the integrated treatment group were significantly lower than those in the conventional treatment group (t =11.977, 17.653, both P<0.05). There were statistically significant differences in the time effect, inter group effect, and interaction effect in repeated measures ANOVA of ankle circumference with two groups of patients one day before surgery, two and three days after surgery (time: F=681.232, group: F=372.328, interaction: F=9.894, all P<0.05). There were statistically significant differences in the time effectand inter group effect in repeated measures ANOVA of VAS scores between the two groups of patients one day before surgery, one day and three days after surgery (time: F=223.310, group: F=17.532, both P<0.05). The Baird Jackson scores of the integrated treatment group were higher than those of the conventional treatment group at one week, one and three months after surgery (Z =-3.526、-5.627、-7.200, all P<0.05). The incidence of complications in the integrated treatment group was lower than that in the conventional treatment group, but the difference was not statistically significant(χ²=2.708, P>0.05).

The integrated orthopedic rehabilitation model can significantly reduce the degree of preoperative ankle swelling, control postoperative pain, shorten the waiting time before surgery and the average hospital stay, improve the quality of ankle function, reduce the risk of complications, and optimize the rapid rehabilitation path after ankle fracture surgery.