Cause Exploration And Prevention Measure For Early Postoperative Complications Of Hip Fracture In The Elderly With Low Energy

Objective: We reviewed our hospital records of low energy hip fracture patients from January 2002 to December 2012, and to investigate the causes of early complications after operation for these hip fractures. According to their specific situation, orthopedic doctors should pay more attention to make effective management and prevention measures for helping patients come through perioperative period smoothly and improving both living quality and therapeutic effect of surgery.Methods: We retrospectively reviewed the treatment records from January 2002 to December 2012, a total of 597 hip fracture patients caused by low energy were collected.The age of them were over 60 years and treated by Artificial hip joint operation or internal fixation surgery. 331 cases of them were male, and 266 cases of them were female. Their age was from 60 to 101 years, and average age was 75.6 years. Of them,212 patients were combined with osteoporosis fracture, and 375 patients were injured by slipping down. Their fracture types were right femoral neck fracture(98 cases), left femoral neck fracture(93 cases), bilateral femoral neck fracture(2 cases), right femoral intertrochanteric(208 cases) fracture and left femoral intertrochanteric fractures(196cases). Their concominant diseases wer hypertension(125 cases), type II diabetes(44cases), cerebrovascular disease(stability more than 6 months, lower limb muscle strength level IV above, 23cases), lung disease(45 cases) and heart disease(myocardial infarction, stable more than 6 months, 23 cases), of whom there were 25 cases combined with two or more diseases. The time of operation were within one week(485patients) or over one week(112 patients). The postoperative follow-up time was from 3to 12 months, and to analyze patients’ early complications and effective prevention measures during hospitalization. Using Harris score and Barthel index to evaluate hip function and daily life ability, respectively.Results:(1) The early complications occured in hospitalization after operation( from 3 to 32days)were anemia(88 cases), delirium(39 cases), Cardio-cerebrovascular disease(23cases), urinary tract infection(18 cases), pulmonary infection(14 cases), electrolyte disorder(13 cases), VTE(12 cases), death(9 cases), first degree of pressure score(3cases), pudendal nerve damage duing to excessive traction(2 cases).(2) The postoperative complications had been controlled effectively by active preoperative and postoperative prevention as well as effective treatment of the related departments.(3) After follow-up from 3 to 12 months, Harris scores were from 85 to 98 scores,an average was 94.5 scores, of whom 561 cases were over 85 scores and the good rate was 94%. Barthel index scores were from 86 to 97 scores, an average was 94 scores, of whom 555 cases were over 90 points and the good rate was 93%. More than 95%patients went back to normal life, and reached satisfactory treatment effect.Conclusion: According to well preoperative preparation, including rectify the disturbance of electrolyte, anemia, prevent lung infection, and thorough treatment,reasonable surgical treatment, close observation of disease, timely supplement of blood volume and blood transfusion, prevention to the postoperative complications and treatment, effective medicine for disease control and treatment could reduce the post operative complications for low energy hip fractures in the elderly.