Hip function in postoperative physical treatment after trochanteric fractures intramedullary and extramedullary fixation

Abstract

Introduction/Objective Postoperative inpatient physical treatment after trochanteric fracture fixation plays an important role in the hip function restoring and promoting overall recovery. The aim of this work was to compare initial and final hip range of motions and general muscle strength (GMS), as well as gender influence on these scores, during the rehabilitation after intramedullary and extramedullary trochanteric fracture fixation.

Method The outcome of physical treatment (hip flexion, extension and abduction, and GMS) was analyzed in 49 patients after a trochanteric fracture fixation by an intramedullary nail (IM group) or self-dynamizable internal fixator (SIF group).

Results There was significant improvement in ranges of all evaluated motions and GMS after postoperative inpatient physical therapy (p < 0.05). There was no significant influence of the gender and age on the observed functional results (p > 0.05). Hip flexion was slightly more improved in SIF group, while GMS was slightly more improved in IM group, but close to the level of statistical significance in both the comparisons (p < 0.2).

Conclusion Inpatient rehabilitation provides significant recovery of injured hip range of motions and GMS after trochanteric fractures internal fixation. Intramedullary and extramedullary fixation are considered similar in the rehabilitation outcome following these patients. The degree of osteoporosis, being generally higher in female patients, does not significantly affect the final functional results.

Keywords: hip function; trochanteric fracture; self-dynamizable internal fixator; intramedullary nail