Effect of early weight-bearing exercise after surgery on intertrochanteric fractures in the elderly_West China Medical Journal

Authors：

LONG Ye , LI Lang , WANG Tong , CHEN Li , LONG Cheng , LIU Jiaxin , XIANG Zhou ,  DUAN Xin

Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

DUAN Xin, Email: dxbaal@hotmail.com

Keywords：

Intertrochanteric fracture; Early; Functional exercise; Modified Barthel Index

DOI：

10.7507/1002-0179.201808084

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Objective To explore the effect of early weight-bearing exercise on the recovery of elderly patients with intertrochanteric fractures after internal fixation. Methods The clinical data of 50 patients with unstable intertrochanteric fractures (AO 31-A2 or A3) who underwent proximal femoral nail treatment between February and August 2015 were collected. Among them, 25 patients underwent early weight-bearing exercise after surgery (the observation group), and 25 patients underwent routine recovery after surgery (the control group). Demographic data of patients, modified Barthel Index, and EuroQOL Five Dimensions Questionnaire (EQ-5D) scores were collected, and mortality was assessed by telephone follow-up one year after surgery. Results In the observation group, the modified Barthel Index before injury, within 48 hours , 6 weeks , 12 weeks, and 1 year after surgery was 49.56±2.00, 26.40±3.11, 44.04±3.92, 47.92±3.13, and 48.76±3.07, respectively; in the control group, the modified Barthel Index at the above mentioned time points was 49.92±0.40, 26.52±3.34, 40.92±2.62, 45.44±2.36, and 49.16±1.75, respectively. The difference between the observation group and the control group at 6 and 12 weeks after surgery was a statistically significant (P<0.05), and the observation group was better than the control group; there was no statistical difference between the two groups in the modified Barthel Index before surgery, within 48 hours after surgery or one year after surgery (P>0.05). None of the patients died within the first one year after surgery. Conclusion The early weight-bearing exercise after hip fracture in the elderly has a positive effect on the recovery of the patients.

Citation： LONG Ye, LI Lang, WANG Tong, CHEN Li, LONG Cheng, LIU Jiaxin, XIANG Zhou, DUAN Xin. Effect of early weight-bearing exercise after surgery on intertrochanteric fractures in the elderly. West China Medical Journal, 2018, 33(9): 1124-1127. doi: 10.7507/1002-0179.201808084 Copy

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6.	Leigheb F, Vanhaecht K, Sermeus W, et al. The effect of care pathways for hip fractures: a systematic overview of secondary studies. Eur J Orthop Surg Traumatol, 2013, 23(7): 737-745.
7.	Leigheb F, Vanhaecht K, Sermeus WA, et al. The effect of care pathways for hip fractures: a systematic review. Calcif Tissue Int, 2012, 91(1): 1-14.
8.	Ziden L, Kreuter M, Frandin K. Long-term effects of home rehabilitation after hip fracture-1-year follow-up of functioning, balance confidence, and health-related quality of life in elderly People. Disabil Rehabil, 2010, 32(1): 18-32.
9.	唐天华, 唐三元, 杨辉. 人工关节置换治疗老年股骨转子间骨折的研究进展. 中国矫形外科杂志, 2014, 22(16): 1481-1487.
10.	Gullberg B, Johnell O, Kanis JA. World-wide projections for hip fracture. Osteoporos Int, 1997, 7(5): 407-413.
11.	Chau PH, Wong M, Lee A, et al. Trends in hip fracture incidence and mortality in Chinese population from Hong Kong 2001-09. Age Ageing, 2013, 42(2): 229-233.
12.	Cheung MY, Ho AW, Wong SH. Operative outcome of Hong Kong centenarians with hip fracture. Hong Kong Med J, 2017, 23(1): 63-66.
13.	Ottenbacher KJ, Smith PM, Illig SB, et al. Hospital readmission of persons with hip fracture following medical rehabilitation. Arch Gerontol Geriatr, 2002, 36(1): 15-22.
14.	Gregersen M, Mørch MM, Hougaard K, et al. Geriatric intervention in elderly patients with hip fracture in an orthopedic ward. J Inj Violence Res, 2012, 4(2): 45-51.

1. 张英泽. 临床创伤骨科流行病学. 北京: 人民卫生出版社, 2009: 150-170.
2. 王欣荣, 应汉杰, 欧阳平凯. 骨质疏松症的发病机理及其治疗. 生物工程进展, 2001, 21(3): 54-56, 49.
3. Chu X, Liu F, Huang J, et al. Good short-term outcome of arthroplasty with Wagner SL implants for unstable intertrochanteric osteoporotic fractures. J Arthroplasty, 2014, 29(3): 605-608.
4. Boldin C, Seibert FJ, Fankhauser F, et al. The proximal femoral nail (PFN) - a minimal invasive treatment of unstable proximal femoral fractures: a prospective study of 55 patients with a follow-up of 15 months. Acta Orthop Scand, 2003, 74(1): 53-58.
5. Saltvedt I, Prestmo A, Einarsen E, et al. Development and delivery of patient treatment in the Trondheim Hip Fracture Trial. A new geriatric inhospital pathway for elderly patients with hip fracture. BMC Res Notes, 2012, 5: 355.
6. Leigheb F, Vanhaecht K, Sermeus W, et al. The effect of care pathways for hip fractures: a systematic overview of secondary studies. Eur J Orthop Surg Traumatol, 2013, 23(7): 737-745.
7. Leigheb F, Vanhaecht K, Sermeus WA, et al. The effect of care pathways for hip fractures: a systematic review. Calcif Tissue Int, 2012, 91(1): 1-14.
8. Ziden L, Kreuter M, Frandin K. Long-term effects of home rehabilitation after hip fracture-1-year follow-up of functioning, balance confidence, and health-related quality of life in elderly People. Disabil Rehabil, 2010, 32(1): 18-32.
9. 唐天华, 唐三元, 杨辉. 人工关节置换治疗老年股骨转子间骨折的研究进展. 中国矫形外科杂志, 2014, 22(16): 1481-1487.
10. Gullberg B, Johnell O, Kanis JA. World-wide projections for hip fracture. Osteoporos Int, 1997, 7(5): 407-413.
11. Chau PH, Wong M, Lee A, et al. Trends in hip fracture incidence and mortality in Chinese population from Hong Kong 2001-09. Age Ageing, 2013, 42(2): 229-233.
12. Cheung MY, Ho AW, Wong SH. Operative outcome of Hong Kong centenarians with hip fracture. Hong Kong Med J, 2017, 23(1): 63-66.
13. Ottenbacher KJ, Smith PM, Illig SB, et al. Hospital readmission of persons with hip fracture following medical rehabilitation. Arch Gerontol Geriatr, 2002, 36(1): 15-22.
14. Gregersen M, Mørch MM, Hougaard K, et al. Geriatric intervention in elderly patients with hip fracture in an orthopedic ward. J Inj Violence Res, 2012, 4(2): 45-51.

West China Medical Journal

Effect of early weight-bearing exercise after surgery on intertrochanteric fractures in the elderly

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