Article

OBJECTIVES: To characterize changes in the gait pattern at 3 and 12 months after
surgery for acetabular fracture, to assess the relationship between various gait
parameters and hip muscle strength, and to determine the factors associated with
gait disorders that correlate with gait parameters measured at 12 months after
surgery. DESIGN: Prospective cohort study. SETTING: University hospital.
PARTICIPANTS: Patients (N=19) with acetabular fractures were treated by open
reduction and internal fixation (ORIF) and examined at 3 and 12 months
postoperatively. The study also included a similar number of sex- and age-matched
control subjects. INTERVENTIONS: Postoperative rehabilitation program. MAIN
OUTCOME MEASURES: Spatiotemporal, kinematic, and kinetic variables of gait and
strength of hip flexor, adductor, and abductor muscles at 3 and 12 months after
ORIF. RESULTS: Walking velocity at 3 months after ORIF was slower in the patients
than in the control subjects; however, walking velocity at 12 months was similar
in the 2 groups. Although most of the kinematic and kinetic variables showed
recovery to control levels at 3 and 12 months after ORIF, recovery was incomplete
for pelvic forward tilt and hip abduction moment even at 12 months after ORIF.
The greatest loss of muscle strength was noted in the hip abductors, where the
average deficit was 35.4% at 3 months and 24.6% at 12 months. There was a
significant relationship between hip abductor muscle strength and hip abduction
moment at 3 months (R(2)=.63); however, this relationship diminished at 12 months
(R(2)=.14). The presence of associated injuries correlated with lack of recovery
of the peak hip abduction moment. CONCLUSIONS: Pelvic forward tilt and peak hip
abduction moment showed incomplete recovery at 12 months after ORIF with
subsequent conventional and home exercise rehabilitation programs. Our results
suggest that improvement of hip abductor muscle strength in the early
postoperative period could improve the peak hip abduction moment.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS