Clinical Observation Of Proximal Femoral Nail Anti Rotation Combined With Rehabilitation Training In The Treatment Of Intertrochanteric Fracture

Femoral intertrochanteric fracture is one of the common hip fractures,especially in elderly patients with osteoporosis.Because of the non operative treatment with complications and high mortality,most of the claims should be carried out at the early stage of surgical treatment.The proximal femur anti rotation intramedullary nail surgical techniques have been developed,although to a certain extent,it can meet the fracture patients recover quickly,but the femoral intertrochanteric fracture postoperative dysfunction is not uncommon in clinical practice,one of the main reasons for nothing better than patients without timely and effective rehabilitation training.ObjectiveRehabilitation training is an important link in the treatment of fracture patients,it is the main way to solve the functional disorder of patients.Therefore,the systematic and standardized rehabilitation training is an important issue in clinical practice.This study was based on the treatment of intertrochanteric fractures with proximal femoral nail anti rotation,with early postoperative rehabilitation training,which is compared with patients treated with conventional surgery alone.Objective to analyze the effect of early rehabilitation training on the functional recovery of patients with intertrochanteric fracture.Methods40 cases of inpatients who were diagnosed with intertrochanteric fracture from the Department of orthopedics of the Second Affiliated Hospital of Bengbu Medical College were selected for the study.20 patients from August 2013 to November 2014were divided into Control group,20 patients from December 2014 to December 2015were divided into treatment group.Patients in the control group were treated with the proximal femoral nail anti rotation intramedullary nail surgery,then the Department of orthopedics doctors only oral guidance patients rehabilitation training,not limited the rehabilitation training frequency.And the treatment group was based on the control group with postoperative professional rehabilitation training,each training method has a certain frequency.Two groups of patients were observed and recorded the pain visual analogue scale of admission and four weeks after surgery;the out of bed time postoperative,fracture healing time and postoperative complications;Barthel index scale of admission,one month and three months after surgery;The Harris hip score at three months after operation.All these data were analyzed statistically,The measurement data were compared with T test,the effectiveness was compared with chi-square test.P<0.05was considered as statistically difference.Results1.Compared with the time of admission,the postoperative visual analogue scores of two groups of patients were decreased in different degree,but the degree of pain in the treatment group was lower than that in the control group after 4 weeks of operation,the difference was statistically significant(P<0.05).2.The time of out of bed and fracture healing time in the treatment group of patients was shorter than the control group,the difference was statistically significant(P<0.05).There were 0 cases of complications in the treatment group and 4 cases in the control group,the difference was not statistically significant(P>0.05).3.Compared with before surgery,two groups of patients with Barthel index were improved.In one month after surgery,patients in the treatment group Barthel index was higher than the control group,the difference was statistically significant(P<0.05),there was no statistical significance(P>0.05)in the two groups after three months.4.Comparison of Harris hip score at three months after operation,the treatment group were superior in 6 cases,good in 13 cases,general in 1 cases and poor in 0cases.The control group were superior in 3 cases,good in 10 cases,general in 5 cases and poor in 2 cases.The clinical effective rate of the treatment group was 95%,better than that of control group(65%).The difference was statistically significant(?~2=3.90,P<0.05).ConclusionsEarly rehabilitation training can reduce postoperative complications in bed of femoral intertrochanteric fractures,which is beneficial to the patients with no weight bearing out of bed,relieve postoperative hip pain,promote the recovery of hip function,and further improve the activities of daily living of elderly patients,it is worth of further study.