| Background:PFNA(Proximal Femoral Nail Antirotation),as one of the operative methods for the treatment of intertrochanteric fracture of the femur in the elderly,has been mastered and applied by orthopedics doctors because of its advantages such as small trauma,fast recovery and early weight-bearing activities after operation.However,due to the basic complications of the elderly patients themselves,there have been long hospitalization,postoperative complications and functional recovery of hip joint are not ideal,quality of life decline and other issues.As a method to help surgical patients recover quickly during the perioperative period,the concept of rapid surgical rehabilitation has the advantages of promoting early rehabilitation exercise,reducing the incidence of perioperative complications,and improving the quality of life of patients.This study is to explore the clinical effect of the combination of the two in the treatment of intertrochanteric fractures in the elderly.Objective:To evaluate the clinical effect of surgical fast rehabilitation concept combined with PFNA in the treatment of intertrochanteric fractures in the elderly,and to explore the clinical significance of surgical fast rehabilitation concept in the treatment of intertrochanteric fractures in the elderly.Method:From November 2017 to November 2019,the elderly patients who were admitted to Beijing FengTai western medicine combined hospital due to intertrochanteric fracture of femur were randomly divided into Enhanced recovery after surgery group Traditional rehabilitation group according to the sequence of admission and the inclusion and exclusion criteria.In this study,57 cases with complete data were finally obtained.According to the different perioperative treatment measures,they were divided into the Traditional rehabilitation grou(28 cases)and the Enhanced recovery after surgery group(29 cases).The general data of sex,age,complications and operation time were compared between the two groups.Record the patient’s hospital stay,postoperative complication rate,visual analogue scale(VAS)of pain before and after surgery,1 week after surgery,and after surgery(month 1 and month 3),before surgery and 1 week after surgery,Postoperative(1st,3rd month)differences in hip joint function Harris score and other indicators.Spss25.0 data processing system is used for processing and analysis.The measurement data conforming to normal distribution is represented by "x±s",the comparison between groups is represented by t test,the measurement data not conforming to normal distribution is represented by "M(QL;QU)",non parameter test is adopted.Chi square test is used for counting data.Result:57 patients in the two groups were followed up by outpatient follow-up.There was no statistical significance between the two groups in terms of gender,age,complications at admission and operation time(P>0.05).There was no significant difference in vas between the two groups(P>0.05);The VAS score of the patients in the Enhanced recovery after surgery group was significantly lower than that in the traditional rehabilitation group(P<0.05).There was no significant difference in VAS score between the two groups(P>0.05).The Harris score of hip joint function in the first and third month after operation in the Enhanced recovery after surgery group was higher than that in the traditional rehabilitation group.There was a significant difference between the two groups in the Harris score of hip joint function in the first and third month after operation(P<0.05).The excellent and good rate of Harris score was 72.4%in the Enhanced recovery after surgery group and 53.5%in the traditional rehabilitation group.The length of stay in the Enhanced recovery after surgery group was shorter than that in the traditional rehabilitation group,and the difference between the two groups was statistically significant(P<0.05).The incidence of postoperative complications was 3.4%in the Enhanced recovery after surgery group and 10.7%in the traditional rehabilitation group.The incidence of postoperative complications in Enhanced recovery after surgery group was significantly lower than that in the traditional rehabilitation group(P<0.05).Conclusion:Through this study,we found that the elderly patients with intertrochanteric fracture of the femur were treated with PFNA operation,combined with the concept of rapid surgical rehabilitation.Through timely assessment after admission,multidisciplinary consultation,perioperative food management and pain management,and early functional rehabilitation,the combination of the two can significantly reduce the postoperative pain,shorten the average length of stay and reduce the operation The combination of PFNA and the concept of Enhanced recovery after surgery is beneficial to the rehabilitation of postoperative patients,which is worth promoting. |
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