The Official journal of the China Association of Rehabilitation of Disabled Persons and the 88th Hospital of PLA

Composite Impact Factor:

0. 948 (2015)

Total citation frequency: 3868 (2015)


ISSN 1005-8478

CN 37-1247/R

Enhanced recovery after surgery program for osteoporotic femoral intertrochanteric fracture in elderly

Author : JI Bin1, 2, LIU Shi-liang2, YANG Dong-fang2, LU Ya-ping2, YU Ge2, XU Ming-min2, XIE Qing2, ZHAO Wei-wei 2, SHI Pei-hua1.     
Working unit : .1. Department of Orthopaedics, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou 310020, China;2. Department of Orthopaedics, The Frist Hospital of Jiaxing City, Jiaxing 314000, China
Page : 1845-1849.
Key words : enhanced recovery after surgery (ERAS), osteoporosis, femoral intertrochanteric fracture, elderly
Abstract: [Objective] To develop enhanced recovery after surgery (ERAS) program for osteoporotic femoral intertrochanteric fractures in elderly, and to explore its clinical outcomes. [Methods] A total of 20 patients who received the ERAS program for osteoporotic femoral intertrochanteric fracture from January 2016 to January 2018 were termed as the ERAS group, while other 20 patients who had conventional surgical treatment program in those days from January 2015 to January 2017 were enrolled as the traditional group. The clinical outcomes were retrospectively compared between the two groups. [Results] All patients in both groups had surgical procedures conducted smoothly. The ERAS group had significantly shorter intervals from injuries to operation than the traditional group (P<0.05) . The ERAS group proved of significantly horter incision length, less intraoperative blood loss, shorter operation time and shorter hospital stay than the traditional group (P<0.05) . In addition, the ERAS group were significantly superior to the traditional group regarding to the postoperative VAS, HAMA and HAMD scores (P<0.05) . All the patients were followed up for 12~18 months. The ERAS group achieved significantly earlier weight-bearing standing after operation, less bone mass loss at 6 months postoperatively and higher Harris scores at the latest follow up than the traditional group (P<0.05) . In term of radiographic assessment, the ERAS group got significantly earlier fracture bony healing than the traditional group (P<0.05) . To the latest follow up, the ERAS group had no loosening, breaking or displacement of internal implants in any patient, whereas the traditional group had 2 cases of internal implant failure, including 1 case of screw cutting out and 1 case of screw withdrawing due to loosening, 1 case of coxavara as well. [Conclusion] This ERAS program does facilitate the improvement of clinical outcomes with advantages of quicker functional recovery, higher safety and reliability for osteoporotic femoral intertrochanteric fracture in elderly.
summary:
Enhanced recovery after surgery program for osteoporotic femoral intertrochanteric fracture in elderly   
JI Bin1, 2, LIU Shi-liang2, YANG Dong-fang2, LU Ya-ping2, YU Ge2, XU Ming-min2, XIE Qing2, ZHAO Wei-wei 2, SHI Pei-hua1.
Orthop J Chin, 27(20):   1845-1849.