Effect of Comprehensive Rehabilitation Training Based on Balance Function on Postoperative Recovery and Function of Hip Fracture in the Elderly: A Systematic Review and Meta-Analysis.

Introduction: In China, the proportion of the elderly population is gradually increasing, followed by the increasing medical demands of elderly patients. Hip fracture is a common fracture in the elderly. The elderly are prone to serious postoperative complications, resulting in failure to restore normal hip function, which seriously affects patients' quality of life and further increases their mortality rate. Thus, hip fracture represents a remarkable public health issue within the realm of geriatric medical care. Significance: This study systematically evaluated the impact of comprehensive rehabilitation training, with a focus on balance function, on elderly individuals with hip fractures' postoperative recovery and functional outcomes. Result: Results showed a significant difference in BBS scores favoring comprehensive rehabilitation training based on balance function over conventional intervention. Similarly, AM-PAC scores favored the balance-focused training. TUTG meta-analysis indicated its adoption in comprehensive rehabilitation training. FIM scores showed improvement with balance-focused training. Harris score meta-analysis also favored this approach. A funnel plot analysis revealed potential publication bias, likely due to study heterogeneity and limited publications. Conclusions: In conclusion, comprehensive rehabilitation training centered around balance function displayed clinical efficacy in enhancing postoperative hip joint function in elderly hip fracture patients. This approach improved balance, coordination, and posture control, facilitating lower limb function recovery and overall prognosis. It holds promise as a valuable treatment approach.

Efficacy of post-surgery family-based participatory cluster pain care in children with developmental dislocation of hip.

BACKGROUND: Developmental dislocation of the hip (DDH) is a common congenital deformity of the skeletal system in children. OBJECTIVE: To investigate the efficacy of post-surgery cluster nursing in children with DDH. METHODS: A total of 60 children with DDH who underwent hip joint orthopedic surgery in our hospital from September 2021 to September 2022 were enrolled as the research participants in this prospective study, and divided into the control group and the observation group according to the numerical table method, with 30 patients in each group. The control group was given routine pain care, and the observation group was given cluster pain care. The hip joint function scores, pain scores, self-rating anxiety score (SAS) were compared between the two groups and between before intervention and after intervention in the two groups. RESULTS: The pain score of the children and the SAS of the primary caregivers after the intervention in the observation group were lower than those in the control group (P< 0.05), and the hip joint function score and family satisfaction degree were higher than those in the control group (P< 0.05). CONCLUSION: Family-based cluster pain care can reduce pain in children with DDH after surgery, promote hip joint functional recovery, reduce the negative emotions of caregivers, and improve family satisfaction, and has clinical popularization value.

Effect of perioperative precision nursing intervention on elderly patients with femoral neck fractures / 现代医院

Objective To investigate the impact and significance of a precision nursing plan during the surgical manage-ment of femoral neck fractures in elderly patients.Methods From May 2022 to May 2023,70 patients with femoral neck frac-tures,including medium-sized neck and head-type,were randomly divided into a control group and an observation group equally.The two groups were managed with routine nursing interventions and specific nursing interventions,respectively.The two groups were compared in terms of the psychological status,complications,hip joint functions,and prognostic effects.Results After the intervention,the psychological status scores of both two groups significantly decreased.The observation group showed lower psy-chological status scores,indicating better psychological status compared to the control group(P＜0.05).The rate of postopera-tive complications in the observation group was significantly lower than that of the control group(P＜0.05).Additionally,the scores of hip joint function in the observation group were higher than those of the control group(P＜0.05).At the time of dis-charge,the scores of self-care ability in both two groups had increased,and the scores of femoral head necrosis were significantly decreased after 3 months of interventions(P＜0.05).Furthermore,the self-care ability scores in the observation group were higher,and the scores of femoral head necrosis were lower compared to those of the control group,indicating that the prognosis of the observation group was better than that of the control group(P＜0.05).Conclusion The precise nursing interventions could effectively enhance the prognosis of elderly patients with femoral neck fractures and improve their self-care ability.

Prediction of hip joint function and analysis of risk factors for internal fixation failure after Femoral Neck System (FNS).

OBJECTIVE: Analysis of the risk factors affecting hip function and complications after femoral neck system (FNS) surgery for femoral neck fractures is of great significance for improving the procedure's efficacy. METHODS: The data of patients with femoral neck fractures who underwent FNS surgery in our hospital between October 2019 and October 2020 were retrospectively analyzed. Age, gender, time from injury to operation, fracture classification, operation time, fracture reduction, and postoperative weight-bearing time information were set as potential factors that may affect the results. Hip Harris scores were performed at 12 months postoperatively, and postoperative complication data (e.g., femoral head necrosis, nonunion, and femoral neck shortness) were collected. The risk factors affecting hip function and complications after FNS surgery were predicted using linear and logistic regression analyses. RESULTS: A total of 69 cases of femoral neck fracture were included, with an average age of 56.09 ± 11.50 years. The linear analysis demonstrated that the age and fracture type of the patients were the risk factors affecting the Harris score of the hip joint after FNS surgery. Older patients with displaced femoral neck fractures had an inferior postoperative hip function. In addition, fracture type, reduction of the femoral neck, and postoperative weight-bearing significantly impacted postoperative complications. Displaced fractures, negative fixation, and premature weight-bearing (< 6 weeks) were risk factors for postoperative complications. The Harris score of patients with a shortened femoral neck in the included cases was not significantly different from that of patients without shortening (P = 0.25). CONCLUSIONS: Advanced age and fracture type are important evaluation indicators of the Harris score after FNS internal fixation of femoral neck fractures in young patients. Fracture type, fracture reduction, and postoperative weight-bearing time are risk factors for complications after FNS.

Effects of alendronate sodium combined with InterTan on osteoporotic femoral intertrochanteric fractures and fracture recurrence.

BACKGROUND: Osteoporosis is a global disease affecting 6.6% of the total population. Osteoporosis complications include fractures, increased bone fragility, and reduced bone strength. The most commonly affected parts are the vertebral body, hip, and wrist. AIM: To examine the effect of alendronate sodium combined with InterTan for osteoporotic femoral intertrochanteric fractures on bone and fracture recurrence. METHODS: In total, 126 cases of osteoporotic femoral intertrochanteric fractures were selected and divided into two groups according to the 1:1 principle by the simple random method. They were admitted to the Department of Orthopedics, First Affiliated Hospital of Xingtai Medical College, from January 2018 to September 2020. The control group was treated with InterTan fixation combined with placebo, and the observation group with alendronate sodium based on InterTan fixation. Operation-related indicators, complications, and recurrent fractures were compared between the groups. Changes in bone metabolism markers, t value for hip bone mineral density, and Harris Hip Score were observed. RESULTS: Operation time, intraoperative blood loss, postoperative ambulation time, and complications were compared between the groups, and no significant difference was found. The fracture healing time was significantly shorter in the observation group than in the control group. ß-Collagen-specific sequence (ß-CTX) and total aminoterminal propeptide of type I procollagen (T-PINP) in the control group at 3 mo after operation were compared with those before operation, and the difference was not significant. Six months after the operation, the ß-CTX level decreased and T-PINP level increased. ß-CTX level at 3 and 6 mo in the observation group after operation was lower, and T-PINP level was higher, than that before operation. Compared with the control group, T-PINP level of the observation group was significantly higher and ß-CTX level was significantly lower at 3 and 6 mo after operation. The t value of hip bone mineral density was compared in the control group before and 1 mo after operation, and significant difference was not found. Compared with the control group, the t value of hip bone mineral density in the observation group was significantly higher at 1, 3, 6, and 12 mo after operation. Compared with the control group, the Harris score of the observation group was significantly higher at 1, 3, 6, and 12 mo after operation. The recurrence rate of fractures in the observation group within 12 mo was 0.00%, which was significantly lower than 6.35% in the control group. CONCLUSION: Alendronate sodium combined with InterTan in the treatment of osteoporotic femoral intertrochanteric fractures can increase bone mineral density, improve hip joint function, promote fracture healing, and reduce fracture recurrence.

[Follow-Up Study of Joint Function and Quality of Life in Patients After Total Hip Arthroplasty].

BACKGROUND: The number of patients with osteoarthritis has gradually increased with population aging. Total hip replacement is typically required in patients with severe arthritis. Because hospitals are reducing the allowable length of hospital stays, joint function recovery and quality of life after surgery are issues of increasing concern in this population. PURPOSE: 1. To track changes in hip function, lower limb function, and health-related quality of life before and after total hip replacement surgery. 2. To examine the correlation between basic demographic data and hip function, lower limb function, and health-related quality of life. METHODS: A longitudinal study with convenient sampling was used. Thirty patients undergoing primary total hip arthroplasty were recruited. Data were collected before the operation and at two weeks, six weeks, and three months after the operation. RESULTS: The results were as follows. (1) At two weeks after the operation, lower limb function and quality of life were significantly worse than before the operation (p < .05). At six weeks and three months after surgery, hip function, lower extremity function, and health-related quality of life were significantly better than before the operation (p < .05). Male patients had better hip function, lower extremity function, and health-related quality of life than female patients (p < .05). Younger people had better lower limb function (p < .05). Those who had jobs and lived with their families had better hip function, lower limb function, and health-related quality of life than those without jobs (p < .05) and those living alone (p < .05). No significant correlation was found between the comorbidities and hip function, lower limb function, or health-related quality of life (p > .05). CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The results may be used as a reference for clinical nurses providing preoperative and postoperative care to patients undergoing total hip arthroplasty.

The effect of biological long stem hemiarthroplasty on postoperative hip joint function in elderly patients with intertrochanteric fractures / 中国医师进修杂志

Objective:To investigate the effect of biological long stem hemiarthroplasty on postoperative hip joint function, serum bone markers, angiotensin Ⅱ (Ang Ⅱ) and cortisol (Cor) levels in elderly patients with intertrochanteric fractures.Methods:A total of 120 elderly patients with intertrochanteric fractures in General Hospital of Northern Anhui Coal and Power Group from June 2017 to June 2019 were selected. According to the principle of non-randomized clinical concurrent controlled study and patient′s voluntariness, they were divided into arthroplasty group and internal fixation group, with 60 cases in each group. Proximal femoral nail antirotation (PFNA) was used in the internal fixation group, and the biological long stem hemiarthroplasty was performed in the arthroplasty group. The related indexes of perioperative operation and complications, the levels of serum AngⅡ and Cor before and after operation, the levels of serum bone markers osteocalcin (OC), calcitonin (CT), alkaline phosphatase (ALP) before and after operation were compared between the two groups. After followed up for 6 months after the operation, Harris hip function score and Barthel index (BI) score, quality of life score (GQOL-74) before and after operation, and the excellent and good rate of hip joint function at 6 months after operation were compared between the two groups.Results:The time of getting out of bed in the arthroplasty group was shorter than that in the internal fixation group, the operation time was longer than that in the internal fixation group, and the amount of blood loss and postoperative drainage were higher than those in the internal fixation group, and the differences were statistically significant ( P<0.05). The postoperative complication rate in the arthroplasty group was lower than that in the internal fixation group: 8.33%(5/60) vs. 25.00%(15/60), and the difference was statistically significant ( χ2 = 6.000, P<0.05). The levels of serum AngⅡ and Cor in the two groups were higher than those before the operation at the 1st and 3rd day after the operation, but the levels of serum AngⅡ and Cor in the arthroplasty group were also higher than those in the internal fixation group: at the 1st day after the operation: (218.68 ± 42.04) mmol/L vs. (158.19 ± 34.36) mmol/L, (327.15 ± 39.08) μg/L vs. (285.42 ± 34.06) μg/L; at the 3rd day after the operation: (169.46 ± 32.73) mmol/L vs. (138.02 ± 25.97) mmol/L, (294.83 ± 33.95) μg/L vs. (262.64 ± 30.57) μg/L, and the differences were statistically significant ( P<0.05). The levels of serum OC, CT, and ALP in the two groups at 1 month and 3 months after operation were higher than those before the operation, the levels of serum OC, CT, and ALP in the arthroplasty group were higher than those in the internal fixation group: at 1 month after operation: (17.40 ± 4.25) μg/L vs. (14.96 ± 3.79) μg/L, (1.34 ± 0.49) ng/L vs. (1.15 ± 0.43) ng/L, (159.49 ± 19.75) U/L vs. (137.24 ± 17.28) U/L; at 3 months after operation: (19.18 ± 5.79) μg/L vs. (16.24 ± 4.36) μg/L, (1.46 ± 0.57) ng/L vs. (1.24 ± 0.50) ng/L, (180.94 ± 22.42) U/L vs. (163.72 ± 19.36) U/L, and the differences were statistically significant ( P<0.05). TheHarris hip function scores at 1, 3 and 6 months after the operation in the two groups were higher than those before the operation, the Harris hip function scoresin the arthroplasty group were higher than those in the internal fixation group, and the differences were statistically significant ( P<0.05). The excellent and good rate of hip joint function at 6 months after operation in the arthroplasty group was higher than that in the internal fixation group: 90.00%(54/60) vs. 75.00%(45/60), and the difference was statistically significant ( χ2 = 4.675, P<0.05). The scores of BI, GQOL-74 at 1, 3, 6 months after operation in the two groups were higher than those before operation, the scores of BI, GQOL-74 at 1, 3, 6 months after operation in the arthroplasty group were higher than those in the internal fixation group, the differences were statistically significant ( P<0.05). Conclusions:Compared with PFNA internal fixation, the treatment of elderly patients with femoral intertrochanteric fracture with biological long stem hemiarthroplasty can promote the recovery of patients, reduce complications, reduce the impact on bone markers, and more effectively improve the patient′s hip joint function, ability of daily living and quality of life, but it is more traumatic to the body and has a strong stress response.

Effect of body mass index on the early-term hip functional recovery after total hip arthroplasty by three-dimensional gait analysis / 中国组织工程研究

BACKGROUND: The impact of obesity on total hip arthroplasty has been discussed. However, there is a lack of follow-up study on the patients with different body mass indexes using three-dimensional gait analysis. OBJECTIVE: To investigate the effect of body mass index on the early-term functional recovery after total hip arthroplasty by three-dimensional gait analysis. METHODS: Sixty patients who underwent total hip arthroplasty at Department of Joint Surgery of Affiliated Zhongshan Hospital of Dalian University from January 2017 to June 2018 were enrolled. According to the body mass index at admission, they were divided into overweight group (body mass index ≥ 25 kg/m2) and normal group (body mass index 0.05). The operation time in the overweight group was significantly longer than that in the normal group (P=0.000). (2) In terms of time-distance parameters, there was no significant difference in the stride length, stride frequency and mean velocity between two groups. The stride length in the overweight group was smaller than that in the normal group (1.08±0.18 vs. 1.35±1.45 m). (3) The range of motion of each planes of hip joint in the overweight group was significantly less than that in the normal group (P < 0.05). (4) In terms of kinetic parameters, the peak torque of hip flexion in the overweight group was significantly less than in the normal group (P=0.011). There was no significant difference in the peak torque of hip extension between two groups (P=1.000). (5) To conclude, obesity has certain effect on the early functional recovery after total hip arthroplasty.

Effects of hip replacement combined with alendronate sodium on postoperative healing of osteoporotic femoral neck fracture and levels of CTX-1 and BALP in patients.

This study aimed to explore the improvement of hip replacement combined with alendronate sodium on the condition of patients with osteoporotic femoral neck fracture and factors affecting the efficacy of patients. In total, 140 patients with femoral neck fracture from July 2015 to October 2017 in the Affiliated Xuzhou Hospital of Jiangsu University were collected. Of these, 61 patients were treated with hip replacement as the control group and 79 patients were treated with alendronate sodium as the observation group on the basis of the control group. ELISA was used to detect levels of carboxy-terminal opeptide of type I collagen (CTX-I) and bone alkaline phosphatase (BALP) in serum of patients before and after treatment. Harris score was used to compare the clinical efficacy of patients after treatment. Changes in the expression of CTX-I and BALP before and after treatment were compared between the two groups, and the correlation between CTX-I and BALP levels and Harris score was analyzed. According to the clinical efficacy of patients, the two groups were divided into the significant effect group and poor effect group. Risk factors affecting the efficacy of patients were analyzed, and the ROC of subjects with risk factors was drawn. After treatment, the expression of BALP in serum increased significantly compared with that before treatment, and the expression of CTX-I decreased significantly. After treatment, the expression of BALP in serum in the observation group was significantly higher than that in the control group (P<0.05). Multivariate analysis revealed that age, time of operation, CTX-I after treatment and BALP after treatment were independent risk factors affecting the efficacy of patients. In conclusion, hip replacement combined with alendronate sodium can effectively improve the clinical efficacy of patients, and age, time of operation, CTX-I after treatment and BALP after treatment are found to be independent risk factors affecting the postoperative efficacy of patients.

The effects of total hip arthroplasty in treating hip bony fusion in young and middle-aged patients with ankylosing spondylitis.

BACKGROUND: This study aims to investigate the curative effects of total hip arthroplasty (THA) in treating hip bony fusion for young and middle-aged patients with ankylosing spondylitis (AS). METHODS: The clinical data of 26 young and middle-aged patients with AS (31 coxae), who were treated with THA and followed-up for more than 3 years in the period between February 1998 and May 2013, were retrospectively analyzed. Among these patients, 22 patients were male (25 coxae) and 4 patients were female (6 coxae). Patients' age ranged within 19-50 years old, with an average of 31.5 years old. The intervals from arthroplasty to the occurrence of hip joint lesions caused by AS ranged within 2-26 years, with an average of 11.2 years. The average Harris score before the surgery was 19.0 ± 11.5 points. RESULTS: Femoral proximal cleavage fracture occurred in one coxa during the surgery and was fixed by the steel wire cerclage. Sciatic nerve traction injury occurred in one coxa after the surgery, which recovered after 6 months. Posterior hip dislocation occurred in one coxa and was immediately treated with manual reduction. All patients were followed-up, and follow-up duration ranged within 36-123 months, with an average of 46.5 months. In the last follow-up, the average Harris score was 87.1 ± 13.1 points, total passive range of motion was 215.0 ± 22.0°, and passive range of flexion was 90.8 ± 9.3°. All these indexes significantly increased compared with pretreatment (P < 0.01). A periacetabular radiolucent line occurred in one coxa with a width of < 2 mm, and no femoral radiolucent line was found during follow-ups in any patient. Heterotopic ossification occurred in four coxae. CONCLUSION: THA treatment for hip bony fusion caused by AS can achieve satisfactory hip function recovery and excellent prosthesis survival rate.

Curative effect of artificial femoral head replacement and its effect on hip joint function and complications of senile patients with femoral intertrochanteric fracture.

Curative effect of artificial femoral head replacement on hip joint function and complications of elderly patients with femoral intertrochanteric fracture were investigated. Eighty patients who were operated for femoral intertrochanteric fractures operation were randomly divided into observation group (n=40) and control group (n=40). The observation group was treated with artificial femoral head replacement, while the control group received internal proximal femur locking plate fixation. In the observation group, the operation time was shorter than that in the control group (P<0.05). The intraoperative bleeding was less than that in the control group (P<0.05). The postoperative indwelling drainage time was shorter than that in the control group (P<0.05). Besides, at 3, 6 and 12 months after operation, 10 m walking speed in the observation group was significantly higher than that in the control group (P<0.05). The 5-time sit-stand time was shorter than that in the control group (P<0.05). At 1 week, 1 month, 3, 6 and 12 months after operation, Harris hip joint scores and visual analogue scale scores in the observation group were both superior to those in the control group (P<0.05). Moreover, the total hospitalization time in the observation group was shorter than that in the control group. Time of walking on crutches and walking without crutches was earlier than that in the control group (P<0.05). The overall proportion of postoperative chronic pain, thrombosis and failed surgery in the observation group was significantly lower than that in the control group (P<0.05). Finally, physical and psychological scores in the observation group after intervention were obviously higher than those in the observation group before intervention and the control group after intervention (P<0.05). Artificial femoral head replacement is characterized by the short operation time, less intraoperative bleeding, fast postoperative recovery of joint function, low degree of pain and fewer complications in the treatment of senile femoral intertrochanteric fracture, which can improve the postoperative life quality of patients.

Clinical efficacy of different surgical methods for treatment of displaced femoral neck fracture in elderly patients / 中国综合临床

Objective To investigate the clinical effect of internal fixation(IF)and total hip replacement(HA)for treatment of displaced femoral neck fracture in elderly patients.Methods Sixty-three cases with femoral neck fracture hospitalized in Chaoyang Central Hospital from January 2010 to January 2015 were selected as research subjects and were divided into IF group(33 cases)and HA group(30 cases) according to the different treatment methods.The patients in IF group were treated with internal fixation and the patients in HA group were treated with hip replacement.The duration of operation,intraoperative blood loss, length of hospital stay,incidence of postoperative complication and reoperation rate in both groups were recorded.The hip function was evaluated by Harris score,and the hip function of the two groups was compared in 1 year,2 years after operation.Results Compared with HA group,the patients in IF group had shorter operation time,less intraoperative blood loss and shorter hospitalization time((0.8± 0.3)h vs.(1.7± 0.2)h;(110.9 ±9.9)ml vs.(587.2±35.7)ml;(16.4±2.0)d vs.(24.8±3.7)d),the differences among the two groups were statistically significant(P=0.041,0.000,0.038).Th incidence of long term postoperative complication was 27.3%(9/33)in IF group and was 10.0%(3/30)in HA group.The reoperation rate was 24.2%(8/33)in IF group and was 6.7%(2/30)in HA group.The differences between the two groups were statistically significant (P=0.045,0.039).The excellent and good rates of hip joint function in HA group after 1 and 2 years after operation were 83.3% and 80.0%,and 63.6% and 57.6% in IF group in 1 and 2 years after operation respectively.The differences between the two groups were statistically significant(P = 0.043,0.042) .Conclusion Internal fixation and hip replacement in the treatment of displaced femoral neck fractures in the elderly effect have their own advantages and disadvantages.Internal fixation has the advantages of less trauma, less blood loss and rapid recovery,but the long-term complications and reoperation rates are higher than those in HA.The long-term clinical effect of HA for the treatment of femoral neck fracture in elderly patients is better than that of internal fixation and it is worthy of clinical promotion.

Analysis of the effects and influence factors of primary total hip arthroplasty in the treatment of senile femoral neck fractures / 中国综合临床

Objective To analyze the effects and influence factors of primary total hip arthroplasty in the treatment of senile femoral neck fractures,and to increase the excellent rate of hip joint function recovery.Methods Retrospective analysis was applied to study the clinical data of one hundred and ten senile femoral neck fractures patients who underwent primary total hip arthroplasty in the 210th Hospital of People's Liberation Army from January 2014 to March 2016,to explore the main factors affecting postoperative recovery of hip joint function.Univariate analysis was used to analyze the factors influencing the clinical efficacy of the patients in terms of gender,age,body mass index,cause of injury,type of fracture and postoperative rehabilitation time,and Logistic regression analysis was used for multivariate analysis.Results The 110 senile femoral neck fractures patients obtained primary total hip arthroplasty,36 cases have seen excellent hip joint function recovery,54 good,15 fair,and 5 poor,with an excellent rate of 81.8 %(90/110).Single factor analyses found that body mass index,preoperative concomitant diseases,surgical approach,operation time,total blood loss, postoperative analgesia,discrepancy in bilateral lower limb lengths,postoperative rehabilitation time and postoperative complications were significantly related to hip joint function recovery(χ2=8.528,12.742,9.912, 8.131,10.404,10.171,12.406,6.412,10.362,P<0.05).According to the multivariate analysis,body mass index,surgical approach,total blood loss,postoperative analgesia,discrepancy in bilateral lower limb lengths,and postoperative rehabilitation time were the main factors affecting hip joint function recovery(Wald χ2=6.213, 4.543,9.156,6.287,5.461,3.698,95%CI=1.17~6.74,1.43~9.15,1.03~5.82,1.29~9.35,0.05~0.62, 0.12~0.93,P<0.05).Conclusion Primary total hip arthroplasty may lead to excellent curative effects for elderly patients with femoral neck fracture.Smaller body mass index,minimally invasive approach,less discrepancy in bilateral lower limb lengths,postoperative analgesia,less total blood loss and longer postoperative rehabilitation time may facilitate postoperative recovery for hip joint function.

Application of Orem self-care mode on hip function recovery of elderly patients with artificial hip replacement / 现代临床护理

Objective To explore the application of Orem self-care mode on hip function recovery of elderly patients with artificial hip replacement . Methods Fifty elderly patients with hip arthroplasty from 2014 January to December were set as control group and received routine nursing methods from 2015 January to December 50 elderly patients with hip arthroplasty , were set as observation group and received Orem self-care mode . The hip function of the two groups was evaluated by Harris scale. Result The hip joint function of observation group was higher than that of control group and the difference was statistically significant (P<0.05). Conclusion Orem self-care mode applied in nursing of elderly patients with hip arthroplasty can improve the recovery of elderly patients with hip function.

Is closed suction drainage effective in early recovery of hip joint function? Comparative evaluation in one-stage bilateral total hip arthroplasty.

One-stage primary bilateral cementless total hip arthroplasty with unilateral closed suction drainage (CSD) was prospectively performed for 51 patients (102 hips), and local effects of CSD were quantitatively evaluated. Postoperatively, pain scores evaluated by visual analog scale and periwound temperatures measured by thermography were lower in the CSD side than the non-CSD side. CT measurements also showed that postoperative cross-sectional area of the thigh was smaller in the CSD side. Active straight leg raising and weight bearing were more accelerated in the CSD side., showing earlier recovery of hip joint function. CSD for hip arthroplasty has an advantage in reducing postoperative local inflammation and be recommended from the viewpoint of postoperative pain relief and early recovery of hip joint function.

A comparative study of the effects of Pilates and conventional rehabilitation treatment after total hip arthroplasty / 中华物理医学与康复杂志

Objective To compare the therapeutic effect of Pilates and conventional training after total hip arthroplasty (THA).Methods Fifty-eight patients who had undergone minimally invasive total hip replacement surgery were divided into an observation group (n =29) and a control group (n =29) using a random number table.The observation group was given Pilates rehabilitation training,including a series of exercises especially designed for this condition,for 6 months after the operation.The control group was provided with conventional postoperative rehabilitation training including passive range of motion exercise,balance training,etc.,lasting for 1 to 2 months in hospital,followed by self-training after discharge.At 1 month,3 months and 6 months after the operation hip joint function was evaluated in both groups using the Harris hip score and the modified Barthel index (MBI).The time for first out-of-bed activity after the operation,length of hospital stay and postoperative complications of the two groups were also recorded.Results At 1 month after the operation,the average Harris hip score and MBI score of the observation group were significantly better than those of the control group [(59.78 ± 6.22) vs (51.26 ± 3.42) and (52.56 ± 16.67) vs (45.63 ± 15.24),respectively].Two and 4 months later,in the observation group the average Harris hip score had improved significantly to (82.12 ± 3.32) and further to (91.42 ± 5.91),while the MBI score increased significantly to (58.39 ± 13.32) and (81.17 ± 13.87).The same tendency was observed in the control group and at those two time points no significant difference was observed between the observation group and the control group.The patients in the observation group had their first out-of-bed ambulation significantly earlier,a significantly shorter average hospital stay and significantly fewer postoperative complications.Conclusion Pilates training after minimally invasive THA can promote earlier and quicker functional recovery than conventional rehabilitation training.

Influence of family rehabilitation education on daily living abilities and function of elderly patients after hip fracture surgery / 中国现代医生

Objective To investigate the influence of family rehabilitation education on the daily living abilities and pa-tient function of elderly patients after hip fracture surgery. Methods Seventy-three elderly patients who received hip fracture surgery were selected and randomly divided into the intervention group with 37 patients and the control group with 36 patients. The control group received conventional hospital discharge guidance and follow-up visits and the in-tervention group received family rehabilitation education;The intervention group was given family rehabilitation educa-tion and followed up for at least 12 months after hospital discharge. The patients ’ joint function, daily living activities and life quality improvement situation were observed. Results Within 12 months after surgery, the Harris hip joint scores of both groups improved significantly (P<0.05) and the hip joint function recovered remarkably; The Harris hip joint scores of intervention group were significantly higher than the control group in 3 months, 6 months and 12 months after the surgery (P<0.05). The FIM scores of intervention group were significantly higher than the control group in 3 months, 6 months and 12 months after the surgery (P<0.05); The GH, PF, RP, BP, MH, VT and RE scores of in-tervention group were significantly higher than the control group in 3 months, 6 months and 12 months after the surgery (P<0.05) and the SF scores was significantly higher than the control group in 6 months and 12 months after the surgery (P<0.05). Conclusion Family rehabilitation is an important step of postoperative function rehabilitation for the el-derly patients after hip facture surgery and the implementation of family rehabilitation education after hospital dis-charge, can help the patients maintain right rehabilitation training, improve hip joint function rehabilitation, daily living abilities recovery and promote the patients ’ life quality.

Comparative study of PFNA and DHS in improving hip joint function of elderly patients with femoral intertrochanteric fracture / 中国现代医生

Objective To compare the effects and safety of proximal femoral nail anti-rotaion (PFNA) and dynamic hip screw (DHS) in improving the hip joint function of elderly patients with femoral intertrochanteric fracture. Methods Ninety-six elderly patients aged over sixty years old with femoral intertrochanteric fracture treated in Department of Or-thopedics from August 2011 to August 2014 were divided into groups according to the hospital admission order. The PFNA group, consisting of 48 patients, was given PFNA treatment, and the DHS group, consisting of 48 patients, was given DHS treatment. The operative time, total intraoperative bleeding amount, hip joint function recovery, fracture healing time and occurrence of operative complications were observed. Results The intraoperative bleeding amount, operative time and fracture healing time of the PFNA group were significantly less than those of the DHS group ( P<0 . 05 ) . The excellent and good rate of hip joint function of the PFNA group was 52.08%, which was significantly higher than the 29.17% of the DHS group (Z=-2.597, P<0.05). The occurrence of postoperative complications of the PFNA group was significantly less than that of the DHS group (P<0.05). Conclusion Compared to DHS, PFNA conforms to the mini-mally invasive principle and the biological and mechanical requirements of modern medicine and its nail anti-rotation system can reduce intraoperative bleeding amount, shorten operative time, promote porosis and early fracture healing, improve hip joint function and reduce the occurrence of postoperative complications, which is quite suitable for elderly patients with femoral intertrochanteric fracture.

Influence of comprehensive nursing intervention on postoperative treat-ment compliance, hip joint function and complication of patients with geriatric hip fracture / 中国现代医生

Objective To discuss influence of comprehensive nursing Intervention on postoperative treatment compli-ance, hip joint function and complication of patients with geriatric hip fracture. Methods A total of 76 cases of patients with geriatric hip fracture were divided into routine nursing group and nursing intervention group with 38 cases of pa-tients in each group, and given the same surgical treatment. The patients in routine nursing group were given orthope-dics routine nursing in perioperative period, while the patients in nursing intervention group were given comprehensive nursing for 6 months. The postoperative recovery of hip joint function and complication of patients in two groups were observed and compared. Results According to 6 months' following-up, the total treatment compliance rate of patients in nursing intervention group was much higher than that in routine nursing group (94.74% vs 76.32%) (χ2=5.21, P<0.05). The good rate of postoperative hip joint function recovery of patients in nursing intervention group was much higher than that in routine nursing group (92.11% vs 73.68%)(χ2=4.55, P<0.05). The occurrence rate of postoperative complication of patients in nursing intervention group was much lower than that in routine nursing group (7.89% vs 26.32%) (χ2=4.55, P<0.05). Conclusion Comprehensive nursing intervention has reliable curative effect on patients with geriatric hip fracture, which can enhance the treatment compliance of patients, improve the postoperative recovery of hip joint function, reduce the postoperative occurrence rate of complication and reduce the disability rate.