老年人股骨粗隆间骨折手术治疗前、后的康复训练研究

Efficacy of rehabilitation training in elderly patients with intertrochanteric femoral fractures underwent surgical operation using dynamic hip screw

目的评价动力髋螺钉治疗老年人股骨粗隆间骨折的疗效,并探讨术前、术后康复训练对手术疗效的影响.方法自2000年10月至2003年4月,采用瑞士内固定协会动力髋螺钉治疗65岁以上老年股骨粗隆间骨折患者86例,随机分为两组:康复组44例,对照组42例,其中康复组术前、术后采取综合康复治疗和训练;对照组进行单纯的手术治疗.术后2组患者定期随访,并比较2组间疗效.结果经过8～42个月(平均26.5±2. 4个月)的随访,2组患者骨折均获得了骨性愈合,其中康复组骨愈合时间平均为(4.6± 0.5)个月,对照组骨愈合时间平均为(4.7±0.4)个月,2组间差异无统计学意义(P>0.05).康复组术后并发症发生率为25.0%,明显少于对照组的发病率52.4%,优良率(88.6%)则高于对照组(76.2%).结论动力髋螺钉治疗老年人股骨粗隆间骨折能获得可靠的固定,系统的康复训练是保证疗效的重要措施,有助于加快患者术后功能康复,提高生活质量.

Objective To evaluate the efficacy of rehabilitation training in treatment of intertrochanteric femoral fractures in elderly patients fixed with dynamic hip screw(DHS). Methods From October 2000 to April 2003, 86 patients over 65 year-old with intertrochanteric femoral fractures fixed by DHS were statistically analyzed and randomly divided into 2 groups, a rehabilitation group (44 patients )and a control group (42 patients ). All the patients underwent surgery to fix the fracture by use of dynamic hip screw. The rehabilitation group patients received comprehensive rehabilitation training before and after surgery, while the control group patients did not. The postoperative comparative study was conducted. Results A follow-up of all the cases for a average of 26.5±2.4 months (8 to 42 months) revealed that all patients achieved bone union, the healing period needed for the rehabilitation group was 4.6±0.5 months, while for the control group was 4.7±0.4 months, with no significant difference between them. The complication in the rehabilitation group was significantly less than that in the control group, while curative effect of joint was significantly superior to control group. Conclusion For intertrochanteric femoral fracture in elderly patients, the reliable fixation could be obtained by using DHS, the rehabilitation therapy was important for enhancing and helping maintain the effect of the surgery. Early rehabilitation intervention was favorable to the patients′ functional recovery and improved their quality of life.