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Type of surgery is associated with pain and walking difficulties among older people with previous hip fracture
Author(s) -
Salpakoski Anu,
Kallinen Mauri,
Kiviranta Ilkka,
Alen Markku,
Portegijs Erja,
Jämsen Esa,
Ylinen Jari,
Rantanen Taina,
Sipilä Sarianna
Publication year - 2016
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/ggi.12552
Subject(s) - medicine , internal fixation , hip fracture , rehabilitation , physical therapy , femoral neck , visual analogue scale , preferred walking speed , surgery , fixation (population genetics) , osteoporosis , population , environmental health
Aim The aim was to assess the level of lower body pain among people with previous femoral neck fracture, and whether the type of surgery was associated with pain and physical function a mean of 2 years after surgery. Methods The study included 115 community‐dwelling older adults aged 60 years and older with previous femoral neck fracture, and 31 reference subjects without previous lower limb injuries. A total of 30 patients had internal fixation surgery, 70 had hemiarthroplasty and 15 had total hip replacement. All patients had surgery in the same hospital and received typical inpatient rehabilitation. From 1.6 months to 7.5 years after the fracture, the patients underwent examination including clinical evaluation, measurements of pain in the lower body (visual analog scale), physical function (maximal walking speed, T imed U p & G o, B erg B alance S cale) and self‐reported walking difficulties. Results Hip fracture patients reported more pain (81 ± 88 mm) compared with the reference group (25 ± 39 mm, P = 0.004). Patients with internal fixation reported significantly more pain than the other study groups. Significantly more patients with internal fixation (53%) reported walking difficulties compared with patients who had hemiarthroplasty (29%, P = 0.028) or total hip replacement (13%, P = 0.018). No significant difference was observed in performance‐based physical function between the fracture groups, but participants in the reference group had better physical function than any of the fracture groups. Conclusions Hip fracture patients treated with internal fixation experienced more pain and walking difficulties than the hemiarthroplasty and total hip replacement groups. Different types of surgical fixation might require different rehabilitation and pain management strategies after hip fracture. Geriatr Gerontol Int 2015; ●●: ●●–●●.