Abstract
Kubota M, Uchida K, Kokubo Y, Shimada S, Matsuo H, Yayama T, Miyazaki T, Takeura N,
Yoshida A, Baba H. Changes in gait pattern and hip muscle strength after open reduction
and internal fixation of acetabular fracture.
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 (R2=.63); however, this relationship diminished at 12 months (R2=.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.
Key Words
List of Abbreviations:
AO/OTA (Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association), ORIF (open reduction and internal fixation)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 05, 2012
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
In-press corrected proof published online on Apr 3, 2012, at www.archives-pmr.org.
Identification
Copyright
© 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
