积极的康复功能训练对老年股骨粗隆间骨折术后恢复的影响

The effect of active rehabilitation training on postoperative recovery of intertrochanteric fracture in the elderly

目的探讨老年股骨粗隆间骨折患者术前及术后进行积极的康复功能训练对功能恢复的影响。方法将2012年10月至2018年10月本院骨科收治的120例股骨粗隆间骨折患者,随机分为对照组与康复组,每组60例。两组均给予行股骨近端防旋髓钉内固定手术治疗,其中康复组患者术前和术后均采取积极的康复治疗和功能锻炼,对照组患者术后进行常规的康复锻炼,比较两组患者术后骨折愈合恢复情况、髋关节Harris评分、康复治疗效果以及并发症发生率。结果两组患者术后骨折均能够得到骨性愈合,其中对照组、康复组骨折愈合时间分别为(26.93±5.79)周、(20.36±4.26)周;住院时间分别为(19.97±3.78)d、(14.26±3.02)d;不完全负重时间分别为(16.00±2.71)d、(11.14±2.06)d;完全负重时间分别为(44.18±6.59)d、(31.29±6.17)d,两组患者比较差异有统计学意义(P<0.05)。对照组康复总有效率、髋关节功能恢复优良率、术后并发症发生率分别为78.3%、80.0%、15.0%,康复组分别为93.3%、95.0%、2.50%,两组患者比较差异有统计学意义(P<0.05)。结论股骨粗隆间骨折患者采用股骨近端防旋髓内钉内固定治疗能够获得良好的固定,积极的术前、术后康复指导和功能训练能够加快患者髋关节功能的恢复,减少术后并发症的产生,对临床治疗具有重要的意义。

Objective To investigate the effect of active rehabilitation training on functional recovery of elderly patients with intertrochanteric fracture before and after operation.Methods From October 2012 to October 2018,120 cases of intertrochanteric fracture of femur were randomly divided into control group and rehabilitation group,with 60 cases in each group.The two groups were all treated with proximal femoral anti-rotation nail internal fixation.The rehabilitation group received active rehabilitation treatment and functional exercises before and after operation,while the control group only received routine rehabilitation exercises after operation.The two groups were compared.The recovery of fracture healing,Harris score of hip joint,curative effect of rehabilitation and incidence of complications were observed.Results Bone healing was achieved in both groups.The healing time of fracture in control group and rehabilitation group was(26.93±5.79)weeks,(20.36±4.26)weeks,hospitalization time was(19.97±3.78)d,(14.26±3.02)d,incomplete weight-bearing time was(16.00±2.71)d,(11.14±2.06)d,and complete weight-bearing time was(44.18±6.59)d,(31.29±6.17)d,respectively.The difference was statistically significant between the two groups(P<0.05).The total effective rate of rehabilitation,the excellent rate of hip function recovery and the incidence of complications after operation were 78.3%,80.0%and 15.0%in the control group and 93.3%,95.0%and 2.50%in the rehabilitation group,respectively.There was significant difference between the two groups(P<0.05).Conclusion Patients with proximal femoral intertrochanteric fractures and screw internal fixation with intramedullary nail fixed treatment can obtain good,active preoperative and postoperative rehabilitation guidance and function training can accelerate the recovery of patients with hip function,reduce the postoperative complications,has the vital significance to clinical treatment,is worth further promotion and application.