Clinical Observation Of Swelling Treatment After Artificial Femoral Head Replacement In Elderly Patients With Intertrochanteric Fracture

Purpose: Through using Diosmin combined with ultrasound transdermal delivery of medicine in treating the operative area edema and the limb swelling which happened in the elderly patients who was suffered from intertrochanteric femoral fractures and received the artificial femoral head replacement. Comparing with the traditional postoperative swelling treatment measures and observing the clinical effect of differences in the treatment of postoperative limb and the operative incision swelling, to explore the feasibility of clinical application. Material and method: From January 2015 to October 2015, 47 elderly patients with intertrochanteric femoral fractures were enrolled from the Second Department of Orthopedics, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine. Age from 70 to 90 years(mean age 79.85±5.6 years), which 21 males, 26 females. All the patients finished preoperative examination and evaluation that no patient had anesthetic or surgical contraindications, met the inclusion criteria. During the study period patients without excluding cases and fall off. All patients were randomly divided into experimental group and control group, experimental group of patients with a total of 23 people, which 11 were male, 12 female; the control group had 24 patients, including 10 males and 14 females. Two groups of patients received the lengthened handle artificial femoral head replacement surgery for the intertrochanteric femoral fractures. The experimental group with postoperative using raising the affected limb, a bag of salt for local pressurization, limb muscle contraction exercise, given Diosmin combined with ultrasound transdermal delivery of medicine at once. While in the control group were treated with postoperative raising the affected limb, a bag of salt for local pressurization, limb muscle contraction exercise and ultrasound transdermal delivery of medicine. Observating and recording the two groups after the first day, and on the third day, and on the seventh day, the fourteenth day, calf shank week diameter, incision swelling, postoperative dressing change times, Harris score, the bacterial culture of secretions around the incision, and recorded the wound healing state. Results: 1. The patients in the experimental group, treated by the corresponding intervention, had better leakage of incision than the patients in the control group in 3 days after surgery. 2. The number of dressing change times,in the early postoperative time(one week),to the experimental group(3.04 + 0.77) is less than it to the control group(4.54 + 1.06). 3. The incision and swelling in the injured limb of the patients in the experimental group began to subside after postoperative 3 days, and there were no obvious swelling in both the operation incision and the limb after postoperative 5 days. Well, the incision and swelling in the injured limb of the patients in the control group began to subside after postoperative 7 days, and the swelling didn’t subside completely until all the surgical sutures were removed(14 days after the surgery). 4. Patients in the experimental group with less postoperative pain than it the control group, the experimental group patients had the Harris score 2.22+0.71, in the third day after the operation, was significantly lower than the control group(Harris score: 3.63 + 0.77). 5. There were no infection in the wounds and delay of removing the surgical suture in both the two groups. Patients in the experimental group did not appear adverse drug reactions and other side effects. Conclusion: 1. With the means using Diosmin combined with ultrasound transdermal delivery of medicine treatment to the elderly intertrochanteric femoral fractures patients, received artificial femoral head replacement,can obtain the effect obviously in treating the incision and limb swelling.At the same time,that can reduce the incision liquid exudation postoperative, and decrease the frequency of dressing change due to the leakage. Lessening the exposure time to the incision so that the risk of wound pollution could be cut down. 2. It is beneficial for the patients to get recovery and have stable physical state because of the reduction of fluid loss after surgery. 3. Patinets feel less pain as the swelling of the incision and of the affected limb were treated,so this therapy reduces the agony of patients after surgery. 4. It can provide a positive effect after surgery to the patients who got the intertrochanteric femoral fracture and received the artificial femoral head replacement operation by using Diosmin combined with ultrasound transdermal delivery of medicine treatment,that is worthy to be popularized.