ObjectiveTo investigate the features of surface electromyography (sEMG) signals of elbow and shoulder muscle groups during maximal isometric contraction of elbow joint, and flexion and extension exercises of elbow joint after elbow fracture surgery. MethodsFrom August, 2021 to April, 2022, 15 convalescent patients after elbow fracture surgery (patient group) and 11 healthy controls (control group) were collected. sEMG signals of biceps brachii, triceps brachii, brachioradialis brachii, upper trapezius, anterior deltoid, middle deltoid and posterior deltoid were recorded during maximal isometric contraction, and flexion and extension exercises of the elbow joint. Root mean square (RMS) value, co-synergy contraction ratio (CSR), co-activation radio (CR), and target muscle activation percentage during flexion and extension were calculated. ResultsIn flexion and extension of elbow joint during maximal isometric contraction, the maximum strength of biceps brachii and triceps brachii were lower in the patient group than in the control group (|t| > 4.109, P < 0.01), and the RMS value of triceps brachii was lower in the patient group than in the control group (t = -7.695, P < 0.001). During maximal isometric extension of elbow joint, the CR of biceps brachii and brachioradialis brachii were more in the the patient group than in the control group (t > 2.326, P < 0.05); during maximal isometric flexion of elbow joint, the CSR of upper trapezius was more in the patient group than in the control group (t = 2.232, P < 0.05). During the extension exercise, the activation level of triceps brachii was more in the patient group than in the control group (t = 3.336, P < 0.05); during flexion exercise, the activation level of biceps brachii and triceps brachii was more in the patient group than in the control group (t >2.339, P < 0.05). ConclusionThere is abnormal contraction pattern of elbow and shoulder muscle groups in patients with elbow fracture after operation, which includes obvious co-contraction pattern of elbow flexor muscle group, insufficient activation of elbow extensor muscle and the compensatory contraction pattern of perishoulder muscle group. sEMG has great potential in quantitative evaluation of motor function after elbow fracture.

ObjectiveTo evaluate the efficacy and safety of a perioperative rehabilitation clinical pathway of acetabular fracture in light of orthopedics rehabilitation team approach. MethodsA prospective randomized control trial was conducted in 82 patients with acetabular fractures who had been admitted from the Emergency Department of Orthopaedic Trauma, Beijing Jishuitan Hospital from June, 2019 to January, 2021. The patients were randomly divided into control group (n = 41) and intervention group (n = 41). The control group was managed routinely, while the intervention group received the rehabilitation clinical pathway, for 24 weeks. The Visual Analogue Score (VAS) of pain, the Barthel Index (BI) and Majeed Pelvic Score were compared. ResultsFinally, 76 patients completed the trial. There was no statistical difference in VAS score between two groups in all periods (|Z| < 1.926, P > 0.05). The BI score was higher in the intervention group than in the control group at discharge, two weeks, six weeks and twelve weeks after operation (|Z| > 2.121, P < 0.05); and no significant difference was found before operation and 24 weeks after operation (|Z| < 1.862, P > 0.05). Majeed Pelvic Score was higher in the intervention group than in the control group two weeks, six weeks, twelve weeks and 24 weeks after operation (|Z| > 2.428, P < 0.05). Six, twelve and 24 weeks after operation, the excellent rate of Majeed Pelvic Score was higher in the intervention group than in the control group (χ² > 6.136, P < 0.05). ConclusionIn comparison with traditional protocol in acetabular fracture, the perioperative rehabilitation clinical pathway was proved effective and of great safety in the light of the integration of orthopedics and rehabilitation mode for improving the function and activities of daily living of patients.