Mitrevska B¹*, Koevska V¹ and Grkova-Miskovska E²

¹Medical Faculty, University Clinic of Physical Medicine and Rehabilitation, University Ss. Cyril and Methodius - Skopje, Republic of North Macedonia
²Department of Physical Medicine and Rehabilitation, City Hospital, Skopje, Republic of North Macedonia

*Corresponding Author: Mitrevska B, Medical Faculty, University Clinic of Physical Medicine and Rehabilitation, University Ss. Cyril and Methodius - Skopje, Republic of North Macedonia.

Received: July 13, 2021; Published: September 23, 2021

Abstract

Introduction: Adult population generally is more sensitive and exposed to various injuries, which means increased opportunity for the emergence of various kinds of geriatric trauma. By increasing average length of life, solving fractures of the upper end of the femur is a major problem for the modern surgery.

Aim of the Study: Aim is to evaluate the effects of treatment and physical rehabilitation with kinesiotherapy and magnetic therapy versus kinesiotherapy and therapy with interference currents of patients with surgically treated pertrochanteric fracture with DHS- type KYLE I, II, according to the protocol results monitoring.

Materials and Methods: The study represents a prospective randomized clinical trial implemented at the Institute for Physical Medicine and Rehabilitation - Skopje. Include two cohorts, with 90 participants with pertrochanteric fracture treated surgically with DHS- type KYLE I, II. Respondents are divided into two groups: Examined group - 45 patients, treated with kinesiotherapy and magnetic therapy and control group - 45 patients treated with kinesiotherapy and therapy with interference currents. Respondents were followed for one year, during which were performed three examinations, the first control on the day of discharge of the hospital, than after 6 and 12 months, from the first review which is input for selected patients who meet the criteria for inclusion in research.

Results: For p > 0.05, there is no statistically significant difference between the groups in terms of the gender of the respondents (Pearson Chi-square = 0.6527, df = 1, p = 0.4191. For p <0.05, a significant difference was found between the respondents from the two groups in terms of the status of formed callus (Pearson Chi-square = 10,181, df = 1, p = 0,0014). It is recognized that, kinesiotherapy and magnetic therapy and kinesiotherapy and interference currents, for p < 0,05, increase Harris hip score (improve the condition of patients) in three time combinations. On physical examination after discharge, 6 and 12 months, Harris hip score for the group treated with magnetic therapy is significantly higher compared with the same in the group treated with interference currents,

Conclusion: In the postoperative rehabilitation of pertrochanteric fractures, with dynamic fixation implant-DHS, therapy of choice is kinesiotherapy and magnetic therapy. It resulted with improvement in the functional status, the stimulation of osteogenesis and quality of life in elderly patients.

Keywords: Pertrochanteric Fracture; DHS-dynamic Hip Screw; Magnetic Therapy; Interference Currents; Kinesiotherapy

References

1. Santora TA., et al. “Management of trauma in eldery patient”. Surgical Clinics of North America 74 (1994): 163-186.
2. Schwab CW and Kauder DR. “Trauma in geriatric patient”. Archives of Surgery 127 (2002): 701-706.
3. Jensen JS. “Classification of trochanteric fractures”. Acta Orthopedica Scandinavica 51 (1980): 1-6: 803-810.
4. Taylor BC., et al. “Long term prediction of incident hip fracture risk in elderly white womwn: study of osteoporotic fractures”. Journal of the American Geriatrics Society9 (2004): 1479-1486.
5. Dargent-Molina P., et al. “Fall-related factors and risk of hip fracture: the Epidos prospective study”. Lancet 9021 (1996): 145-149.
6. DeMaria EJ., et al. “Survival after trauma in geriatric patients”. Annals of Surgery 206 (1987): 738-743.
7. Moseley AM., et al. “Mobility training after hip fracture: a randomised controlled trial”. Age Ageing1 (2009): 74-80.
8. Mitrevska B., et al. “Rehabilitation and Harris hip score in patients with DHS surgically treated pertrochanteric Kyle fracture type I,II”. Physioacta 2 (2016): 1-12.
9. Marottoli RC., et al. “Decline in physical function following hip fracture”. Journal of the American Geriatrics Society 40 (1992): 861-866.
10. Sharrard WJ. “A double- blind trial of pulsed electromagnetic fields for delayed union of tibial fractures”. Journal of Bone and Joint Surgery. British 3 (1990): 347-355.
11. Borsalino G., et al. “Electrical stimulation of human femoral intertrochanteric osteotomies. Double-blind study”. Clinical Orthopaedics and Related Research 237 (1998): 256-263.
12. Seitz DP., et al. “Prevalence of dementia and cognitive impairment among older adults with hip fractures”. Journal of the American Medical Directors Association 8 (2011): 556-564.
13. Huusko TM., et al. “Randomized, clinically controlled trial of intensive geriatric rehabilitation in patients with hip fracture: subgroup analysis of patients with dementia”. British Medical Journal 321 (2000): 1107-1111.
14. Oldmeadow LB., et al. “No rest for the wounded: early ambulation after hip surgery accelerates recovery”. ANZ Journal of Surgery7 (2006): 607-611.
15. Beaupre LA., et al. “Maximinising functional recovery following hip fracture in frail seniors”. Best Practice and Research: Clinical Rheumatology 6 (2013): 771-788.
16. Portegijs E., et al. “Effects of resistance training on lower- extremity impairments in older people with hip fracture”. Archives of Physical Medicine and Rehabilitation9 (2008): 1667-1674.
17. Liang C., et al. “Efficacies of surgical treatments based on harris hip score in eldery patients with femoral neck fracture”. International Journal of Clinical and Experimental Medicine5 (2015): 6784-6793.
18. Zuh SG., et al. “Correlations between the Harris hip score and Visual Analogue Scale in the assessment of total hip replacement in hip dysplasia”. ARS Medica Tomitana76 (2004): 6-13.
19. Hoeksma HL., et al. “Comparison of the responsiveness of the Harris Hip Score with generic measures for hip function in osteoarthritis of the hip”. Annals of the Rheumatic Diseases 62 (2003): 935-938.

Citation

Citation: Mitrevska B., et al. “Mitrevska B”. Acta Scientific Orthopaedics 4.10 (2021): 67-74.

Copyright

Copyright: © 2021 Mitrevska B., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.