Effect of types of proximal femoral fractures on physical function such as lower limb function and Activities of Daily Living.

Physical therapy research Pub Date : 2020-09-28 eCollection Date: 2021-01-01 DOI:10.1298/ptr.E10050
Daisuke Bai, Mitsunori Tokuda, Taiki Ikemoto, Shingo Sugimori, Shoki Okamura, Yuka Yamada, Yuna Tomita, Yuki Morikawa, Yasuhito Tanaka
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Abstract

Objectives: This study aimed to assess physical function such as lower limb function and Activities of Daily Living after surgery for proximal femoral fractures ( unstable medial femoral neck fracture and trochanteric fracture).

Methods: This study enrolled 68 patients with proximal femoral fractures. Isometric knee extension strength (IKES), the Japanese Orthopedic Association (JOA) hip score, and the number of days required to develop straight leg raising, transfer, and T-caneassisted gait abilities to become independent were assessed. Patients were classified based on the types of proximal femoral fractures, namely unstable medial femoral neck fracture (bipolar hip arthroplasty [BHA] group), stable trochanteric fracture (S group), and unstable trochanteric fracture (US group).

Results: IKES and the JOA hip score were significantly better in the BHA group than in the S and US groups. IKES and the JOA hip score were significantly worse in the US group than in the BHA and S groups. Both transfer and T-cane-assisted gait abilities of patients in the BHA and S groups were indifferent. However, all physical functions were significantly worse in the US group.

Conclusions: Our study results suggested that physical therapists plan the different rehabilitation program for the patients with proximal femoral fractures who were classified into three types, namely unstable medial femoral neck fracture, stable trochanteric fracture, and unstable trochanteric fracture, instead of two types.

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股骨近端骨折类型对肢体功能及日常生活活动的影响。
目的:本研究旨在评估股骨近端骨折(不稳定股骨颈内侧骨折和股骨粗隆骨折)术后的肢体功能,如下肢功能和日常生活活动。方法:本研究纳入68例股骨近端骨折患者。评估等长膝关节伸展强度(kes)、日本骨科协会(JOA)髋关节评分,以及发展直腿抬高、转移和t -can辅助步态能力以独立所需的天数。根据股骨近端骨折类型对患者进行分类,分别为不稳定股骨内侧颈骨折(双相髋关节置换术[BHA]组)、稳定粗隆骨折(S组)和不稳定粗隆骨折(US组)。结果:BHA组的kes和JOA髋关节评分明显优于S和US组。美国组的kes和JOA髋关节评分明显低于BHA和S组。BHA组和S组患者的转移和t -手杖辅助步态能力均无差异。然而,美国组的所有身体机能都明显更差。结论:我们的研究结果表明,物理治疗师对股骨近端骨折患者的康复方案不同,将其分为不稳定股骨颈内侧骨折、稳定股骨粗隆骨折和不稳定股骨粗隆骨折三种类型,而不是两种类型。
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