Résumé
Objective To analyse the risk factors of medical complications after hip fracture surgery.Methods Clinical data of 327 hip fracture patients undergoing surgical treatment in Beijing Haidian Hospital from January 2009 to December 2013 were retrospectively studied.There were 114 males and 213 females with a mean age of (75.1 ±15.6) years, 129 patients(39.4%) had femoral neck fractures, and 198 patients ( 60.6%) had intertrochanteric fractures.Fifty four patients had medical complications during hospitalization ( complication group) and 273 patients did not have complications ( non-complications group ) . The clinical features, presurgical comorbidities and operative parameters were documented and compared between two groups.The risk factors of medical complications were assessed by regression analysis.Results Univariate analysis showed that age ( t =2.85, P=0.007), lying in bed before fracture(χ2 =12.86,P =0.000), the history of chronic obstructive pulmonary diseases(COPD) (χ2 =9.45, P=0.000), coronary heart disease(χ2 =10.67,P=0.000), heart failure(χ2 =15.85,P=0.000), diabetes (χ2 =3.22,P=0.024), cerebrovascular disease(χ2 =4.21,P=0.008), anesthesia method(χ2 =8.67,P=0.018), American Society of Anesthesiologists(ASA) score ≥3 level(χ2 =2.01, P=0.042) and the delay time of operation (t=4.24, P=0.037) were significantly different between two groups.Multivariate regression analysis revealed that age(β=0.030, OR=1.030), lying in bed before fracture (β=2.303, OR=10.716), the history of COPD (β=0.831, OR =1.995), coronary heart disease(β=0.858, OR=2.392), heart failure(β=1.971, OR=7.333)and ASA score ≥3 level(β=0.809,OR=2.583) were the independent risk factors of medical complications after hip fracture surgery. Conclusion Age, lying in bed before fracture, the history of COPD, coronary heart disease, heart failure and ASA score≥3 level would increase the risk of postoperative medical complications for patients with hip fracture.
Résumé
@#Objective To evaluate the effect of continuous passive motion (CPM) as an adjunct to active physiotherapy on pain and range of motion (ROM) after knee arthroplasty. Methods 20 female osteoarthritis patients (40 knees) undergoing bilateral knee arthroplasty were assigned into two groups. The experimental group received CPM and active physiotherapy twice a day while the control group received active physiotherapy only. They were assessed with visual analogue scale (VAS) and goniometer on pain and ROM of knee before and after operation. Results There were no statistical difference between these two groups for any outcome measures either 2 weeks or 3 months after operation (P>0.05), and they all improved in pain and ROM 3 months after operation compared with before (P<0.01). Conclusion CPM as an adjunctive therapy is not found to have an additional effect on pain or ROM 3 months after operation while active physiotherapy was used.