[Application of accelerated rehabilitation program for the treatment of intertrochanteric fracture of femur in the elderly]

Abstract

Objective: To evaluate the clinical value of accelerated rehabilitation in the treatment of intertrochanteric fracture of femur in the elderly.

Methods: Eighty elderly patients with intertrochanteric fractures were selected from January 2016 to October 2018, and were divided into accelerated rehabilitation group and traditional rehabilitation group according to different treatment schemes, 40 cases in each group. There were 22 males and 18 females in accelerated rehabilitation group with an average age of (78.5±9.1) years old; 19 males and 21 females in traditional rehabilitation group with an average age of (80.6±8.1) years old. The perioperative blood loss, incidence of complications, hospitalization time, hospital stay, Harris hip score and improved BADL scale were compared between the two groups.

Results: Eighty patients were followed up for more than 12 months, with an average follow-up time of (15.4±2.6) months. The total perioperative blood loss in the accelerated rehabilitation group was significantly lower than that in the traditional rehabilitation group(P<0.001). Although the incidence of complications in the accelerated rehabilitation group was lower than that in the traditional rehabilitation group, there was no significant difference between the two groups(P>0.05). The time from admission to operation of the accelerated rehabilitation group(1.48±0.51) days was significantly shorter than that of the traditional rehabilitation group(4.35±1.55) days(P<0.01);the hospitalization time of the accelerated rehabilitation group was(6.4±1.1) days was significantly shorter than that of the traditional rehabilitation group (9.9±1.9) days(P<0.01). At 12 months after operation, there was no significant difference in Harris score between the two groups(P>0.05), and there was no significant difference in modified BADL score between the two groups(P>0.05).

Conclusions: The application of accelerated rehabilitation program in elderly intertrochanteric fracture is safe and effective. It can reduce perioperative bleeding, shorten hospitalization time and accelerate the recovery of hip function.

Keywords: Femur; Hip fractures; Osteoporosis; Perioperative period; Rehabilitation.