The Exploration Of Postoperative Rehabilitation Of Intertrochanteric Fracture By PFNA Internal Fixation Under The Guidance Of The Theory Which Emphasis On Both Sinews And Bones

Objective:By analyzing the different curative effect of the postoperative patients of intertrochanteric fractures by PFNA internal fixation who adopt different methods to recover, the research explores the theory which emphasis on both sinews and bones and postoperative rehabilitation programs, and analyzes the principle of PFNA internal fixation and the relationship between fracture healing and pulmonary physiotherapy. It tries to provide reference for postoperative functional rehabilitation of intertrochanteric fractures.Methods:The research collects 84 hospitalized patients from January2014 to June 2015 who use intertrochanteric fractures by PFNA internal fixation as the main diagnosis in Orthopedics of Hubei Traditional Chinese Medicine Hospital and Wuhan General Hospital of Guangzhou Military.The patients are from 55 to 88 the average age of69.72±3.57, 36 male patients and 48 female patients, 45 cases of left side, 39 cases of right side. Patients are divided into two groups, one group composition of 42 patients for the observation group, namely postoperative patients with scientific and reasonable exercise under the guidance of the traditional theory which emphasis on both sinews and bones; Another group composition of 42 patients for control group,patients with Routine rehabilitation exercise after operation training,the training depend on the patients themselves, no theoretical guidance.It compares by using X-ray of the SANDER’s traumatic hip score standard to analyze recovery of the intertrochanteric fracture, and guides postoperative functional exercise by combining with the theory which emphasis on both sinews and bones. Evaluating curative effect is by Harris hip score hip rehabilitation.Results:84 surgical patients are received follow-up study, 6 to16 months, an average of 14.3 months. All fractures are achieved clinical healing standard. The average healing time of two groups is 13.54 ±2.67 weeks and 13.54 ± 1.59 weeks, which shows the observation group was shorter than that of the control group,but the difference between the two groups could not be compared.No internal fixation failure, infection, delayed healing of wound, lower extremity deep vein thrombosis were found. On the hip joint function score, when discharged and one month after the scores of the two groups had no significant difference(P > 0.05), the two groups that the recent rehabilitation effect had no significant difference; three months after discharge, the t test scores of the two groups were significantly different(P < 0.05), the observation group score was 87.63 ±6.84,24 score of excellent, good in 11, the excellent rate was 83.33%, the control group score was 79.15 ± 2.87, according to the standard and reached 18 people, in 10, the excellent rate was 66.67%;nine months after discharge, the t test scores of the two groups were significantly different(P < 0.05) the observation group was 93.21 ±3.83, standard, up to 39 people in more than an excellent good rate of 92.86%, the control group score was 83.53 ± 1.96, which indicates differences of the two groups in the long-term rehabilitation effect are obvious.Conclusion:Under the guidance of the theory which emphasis on both sinews and bones, postoperative rehabilitation of intertrochanteric fractures by PFNA internal fixation can promote the improvement of the hip joint function and activity, and is good for the hip joint function.PFNA used lateral femoral and implanted spiral blade with small surgical trauma and less blood loss, which can reduce femoral neck blood circulation and bone destruction, conforms to the principle of femur bones and is helpful for the early healing of fracture. It can conclude that postoperative rehabilitation of intertrochanteric fractures is feasible and advantageous under guidance of the theory which emphasis on both sinews and bones.