FEATURES OF REHABILITATIVE TREATMENT OF ELDERLY PATIENTS AFTER FRACTURES OF THE PROXIMAL FEMUR: ANALYSIS OF METHODS AND APPROACHES

Objective of the study: This study aims to compare the effectiveness of different treatment methods in elderly patients who have suffered a fracture of the proximal femur.
Materials and methods: The research was conducted between 2022 and 2024 at the state autonomous healthcare institution “City Clinical Hospital No. 7 named after M.N. Sadykov” (Kazan, Russia). The study included 150 patients randomised to four groups. Group 1: patients after osteosynthesis with restorative treatment (n=37), Group 2: patients after osteosynthesis without restorative treatment (n=38), Group 3: patients after endoprosthesis with restorative treatment (n=38), Group 4: patients after endoprosthesis without restorative treatment (n=37). Rehabilitation treatment included physical therapy (PT) and physiotherapy. All patients received basic medical therapy, including non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics.
Results: The mean pain scores (VAS) at baseline were 8.0±0.5 (group 1), 7.9±0.4 (group 2), 7.8±0.3 (group 3) and 7.7±0.4 (group 4). After one month of treatment, the values decreased to 3.9±0.3, 5.4±0.4, 4.1±0.3 and 5.8 ± 0.5, respectively. After three months, the values were 1.5±0.2, 3.7±0.3, 1.8±0.2 and 4.2±0.4, respectively. The analysis showed a significant improvement in patients who received restorative treatment compared to those who did not receive restorative treatment (p< 0.001). Additionally, similar significant improvements were seen on the Harris Scale, the Quality of Life Scale (SF-36), and Motor Assessment Scale. In general, rehabilitation treatment resulted in reduced pain and enhanced functional performance in patients with fractures of the proximal femur. Conclusion: Our study confirmed a significant improvement in outcome in patients with proximal femoral fractures treated with surgery combined with physiotherapy and exercise. These data are important for developing clinical recommendations and optimising standards of care for this group of patients.

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