关键词:

老年股骨颈骨折, 持续被动活动, 阶段性康复锻炼, 髋关节, 股静脉血流

Abstract:

Objective　To observe the effect of continuous passive activity therapy combined with phased rehabilitation exercise on postoperative rehabilitation of elderly patients with femoral neck fractures. Methods　A total of 113 elderly patients with femoral neck fractures admitted to the First Affiliated Hospital of Nanyang Medical College from January 2022 to March 2023 were prospectively selected as the study objects. The patients were divided into an exercise group (56 cases) and a combined group (57 cases) after the random sequence was generated by computer randomization method and assigned to hide. There were 33 males and 23 females in the exercise group, aged 65-75 (70.25±5.42) years, the course of disease was 7-14 (10.24±2.33) d, and the Garden fracture type was type II in 30 cases and type III in 26 cases. There were 34 males and 23 females in the combined group, aged 67-73 (70.36±5.33) years, the course of disease was 8-13 (10.32±2.19) days, and the Garden fracture type was type II in 32 cases and type III in 25 cases. All patients underwent surgical treatment. The exercise group received phased rehabilitation exercise after surgery, and the combined group received continuous passive activity therapy combined with phased rehabilitation exercise. Both groups were treated for 1 month and followed up for 1 year after treatment. The range of hip joint motion (flexion, extension, external rotation, and adduction), hip joint function [Harris Hip Score (HHS) and Visual Analogue Scale (VAS)], femoral vein blood flow parameters [peak flow velocity (Vp), mean flow velocity (Va), blood flow (BF), and flow resistance index (RI)] were compared between the two groups. Independent sample t test, paired t test, and χ² test were used. Results　After treatment, the motion ranges of hip joint flexion [(80.33±10.45)°], extension [(12.33±3.25)°], external rotation [(33.49±5.41)°], and adduction [(50.23±10.45)°] in the combined group were greater than those in the exercise group [(75.29±10.41)°, (10.39±2.44)°, (30.25±5.28)°, and (45.22±10.36)°] (all P<0.05). The HHS scores [(73.35±10.25) points and (82.49±10.44) points] in the combined group were higher than those in the exercise group [(68.42±10.44) points and (77.69±10.36) points] after 6 and 12 months of follow-up, and the VAS scores [(4.33±1.25) points and (2.28±0.46) points] were lower than those in the exercise group [(5.29±1.36) points and (3.36±0.45) points] (all P<0.05). After treatment, the Vp [(70.23±10.44) cm/s] and Va [(45.33±10.26) cm/s] of femoral vein in the combined group were higher than those in the exercise group [(65.44±10.28) cm/s and (40.29±10.36) cm/s], and the BF [(0.75±0.16) L/min] and RI [(1.33±0.72) kPa/s] were lower than those in the exercise group [(1.25±0.46) L/min and (1.62±0.41) kPa/s] (all P<0.05). Conclusion　Continuous passive activity therapy combined with phased rehabilitation exercise can improve the range of hip joint motion and hip joint function in elderly patients with femoral neck fractures after operation, and has positive significance in promoting the recovery of femoral vein blood flow.

Key words:

Elderly femoral neck fractures, Continuous passive activity, Phased rehabilitation exercise, Hip joint, Femoral venous blood flow