FUNCTIONAL ASSESSMENT OF THE PATIENTS OF PROXIMAL FEMUR FRACTURE
Naoyuki Oi, Tsutomu Iwaya, Kenji Suzuki (Tohoku University, Sendai, Japan)
PURPOSE. To study the relationship between proximal femur fracture and disability in the elderly.
METHOD. Thirty five patients aged 60 and over (average age 78.7 years) with proximal femur fracture treated with endoprosthesis, sliding lag screw, cancellous screw, or Ender nailing, related to the fracture type were analyzed. Measurement of function was assessed by ability to perform eight basic and four instrumental activities of daily living (ADL). And we measured range of motion of hip and knee joint, muscle strength, osteoporosis, articulo-trochanteric distance on X-ray film, Trendelenburg sign, sit and reach test, pain of hip and knee joint, walking speed, and dementia scale.
RESULT. Impaired function after proximal femur fracture was showed as difficulty performing two basic and instrumental ADLs (comparison between average performing points 10.1 before fracture and 8.3 on investigation). And we determine that range of motion of hip extension is the factor associated with impaired function in hip fractured patients.
CONCLUSION. Deduction of the effect of age on disability, it is pointed out that impaired function is occurred after proximal femur fracture. Range of motion of hip extension is the factor associated with disability in hip fractured elderly patients.
QUALITY OF LIFEIMPROVEMENT AFTER TRANSTROCHANTERIC ROTATIONAL OSTEOTOMY OF AVASCULAR NECROSIS OF THE FEMORAL HEAD
Tsuyoshi Nakai (Yao City Hospital, Yao Japan), Kensaku Masuhara, Lee Seung Bak, Minoru Matsui, Takahiro Ochi (Osaka Univasity Medical School, Osaka, Japan)
Quality of life (QoL) assessment is becoming an increasingly important to demonstrate clinical success of operative treatment. Transtrochanteric anterior rotational osteotomy (TARO) has been proposed as one of joint-preserving operation for patients with avascular necrosis of the femoral head (ANF). However QoL assessment after TARO has not been thoroughly studied so far. We aimed to determine by a retrospective trial whether there is a difference in QoL before and after operation.
We studied 20 patients with ANF before and after TARO. There were ten male and ten female patients who were 20 to 55 years old (mean, 33 years old) at the time of the operation. Disability and distress were assessed by the Harris hip score, which was used to generate QoL scores using the Rosser Index Matrix. Twelve patients increased their QoL scores, and one had no change. Seven patients decreased their scores, and four of them subsequently needed a total hip replacement. The median preoperative and postoperative score was 0.892 (range 0.870 to 0.986) and 0.960 (range 0.870 to 1.000) respectively. There was no statistically significant difference in the improvement in QoL scores between before and after surgery. These findings could suggest that TARO indication for ANF patients should be determined based on more strict criteria.