【論文摘要】Investigation of the Effects of an Early Mobilization Post-Acute Care Program for Unstable Intertrochanteric Fracture

【論文摘要】探討不穩定型轉子間骨折術後立即承重之急性後期照護計畫之效果

李家媛(Jia-Yuang Li) ； 張啟軒(Chi-Hsuan Chang) ； 蘇希洵(Hsi-Hsun Su) ； 謝悅齡(Yueh-Ling Hsieh) ； 簡温原(Andy Chien)

《物理治療》 43卷4期 (2018/12) Pp. 298-298

https://doi.org/10.6215/FJPT.201812.O05

摘要

Background and Purpose: Geriatric patients with unstable intertrochanteric (ITC) fracture are at higher risk of mortality and permanent disability after surgery. Although extensive evidence has suggested that mobilization should begin within 48 hours postoperatively, such practice isn't consistent for all surgeons, due to the concerns of hardware failure associated with early weight bearing. This has led to an area of heated controversy for the rehabilitation of unstable ITC fracture patients post-operatively. Therefore, the aim of this study was to investigate the effects of a Post-Acute Care (PAC) program involving early mobilization within 2-weeks post unstable ITC fracture surgery. Methods: 16 unstable ITC fracture patients (65 years or older) were enrolled and followed for 3 months. These patients were allocated to either the PAC program (experimental group) which involved immediate weight bearing interventions or usual care program (control group) which allowed only partial weight bearing starting 4-week after surgery. The outcome measurements were the change in Harris Hip Score (HHS) and Barthel Index. Results: Five of the participants were included in the PAC program. Demographics and pre-fracture status were similar between groups. The HHS demonstrated a similar pattern of recovery between groups but the Barthel Index Scale for the PAC group showed significant improvements compared to the control group. Conclusion: PAC with early mobilization yielded no additional improvements in increasing HHS compared to control group whilst the Barthel Index score did show observable improvements. Clinical Relevance: Our results provided promising information to advocate the practice of early weight bearing for unstable ITC fracture patients in Taiwan.