gms | German Medical Science

Objective: Hip fracture is the most common trauma among elderly population (90%).

The objective of this study was to compare the level of functional recovery and improvement in local findings before and after medical rehabilitation, in elderly patients with internal fixation after hip fracture.

Material/Methods: 30 patients with surgically treated hip fracture (internal fixation with Gamma 3 nail) were included in this research. We registered comorbidities, the time from surgical intervention until admission to Clinic for medical rehabilitation and duration of inpatient rehabilitation in all patients. We assessed the range of active movements of the hip, muscular strength measured by the manual muscle test and functional outcomes using Harris hip score, on admission and at discharge from our institution. Physical therapy included intensive kinesitherapy, occupational therapy and electromagnetic therapy (unless there were contraindications for its implementation).

Results: The average age of patients was 76 years. Cardiovascular disease were the most common comorbidity (65%). The average time from surgical intervention until admission to Clinic for medical rehabilitation was 41 days. The average duration of inpatient rehabilitation was 23 days. All parameters showed statistically significant improvement in local and functional recovery, after physical therapy (p<0.01). There is statistically significant correlation between range of active movement of the hip joint and Harris hip score. Two patients were excluded from the program of medical rehabilitation because of medical complications due to comorbidities and complication.

Conclusion: Early mobilisation of the patient together with carefully designed and dosed program of medical rehabilitation, adapted to the elderly patients and their other diseases is very important for a successful functional and local recovery.