Fei Xing1, Lang Li1, Wei Chen1, Zhou Xiang2. 1. Department of Orthopaedics, West China Hospital, Sichuan University, No. 37 Guoxue lane, 610041 Chengdu, Sichuan, China. 2. Department of Orthopaedics, West China Hospital, Sichuan University, No. 37 Guoxue lane, 610041 Chengdu, Sichuan, China. Electronic address: xiangzhouI5@hotmail.com.
Abstract
BACKGROUND: Currently, few studies focus on the treatment of Parkinson's disease (PD) patients after a fracture. The effect of PD on geriatric patients with intertrochanteric fracture remains unclear. Therefore, we performed a study to focus on two questions as follow: (1) would PD increase the operation difficulty and perioperative complications in Chinese elderly patients with intertrochanteric fracture? (2) is there any difference between the clinical outcome of patients with and without PD? HYPOTHESIS: PD would increase perioperative complications and influence the postoperative rehabilitation in elderly patients with intertrochanteric fracture. MATERIALS AND METHODS: There were 445 elderly intertrochanteric fracture patients treated with proximal femoral nail anti-rotation during January 2010 and December 2017. After propensity score matching, twenty-four geriatric intertrochanteric fracture patients with PD and forty-eight geriatric intertrochanteric fracture patients without PD were enrolled in this retrospective study. Intraoperative and postoperative comparison were conducted between patients with and without PD. RESULTS: Compared with 63 months for geriatric intertrochanteric fracture patients without PD, patients with PD had a median survival time of 31 months. The Harris Hip Score and Barthel Index of patients with PD were significantly lower than that of patients without PD. In addition, the Depression subscale score of patients with PD were significantly higher that of patients without PD. DISCUSSION: The effect of PD on geriatric patients with intertrochanteric fracture is not the operation itself, but the postoperative rehabilitation. In addition, multi-disciplinary treatment, personal rehabilitation training, more intensive outpatient care, and meticulous nursing were recommended in treatment for elderly patients with intertrochanteric fracture and PD. LEVEL OF EVIDENCE: III, Cohort comparative study.
BACKGROUND: Currently, few studies focus on the treatment of Parkinson's disease (PD) patients after a fracture. The effect of PD on geriatric patients with intertrochanteric fracture remains unclear. Therefore, we performed a study to focus on two questions as follow: (1) would PD increase the operation difficulty and perioperative complications in Chinese elderly patients with intertrochanteric fracture? (2) is there any difference between the clinical outcome of patients with and without PD? HYPOTHESIS: PD would increase perioperative complications and influence the postoperative rehabilitation in elderly patients with intertrochanteric fracture. MATERIALS AND METHODS: There were 445 elderly intertrochanteric fracturepatients treated with proximal femoral nail anti-rotation during January 2010 and December 2017. After propensity score matching, twenty-four geriatric intertrochanteric fracturepatients with PD and forty-eight geriatric intertrochanteric fracturepatients without PD were enrolled in this retrospective study. Intraoperative and postoperative comparison were conducted between patients with and without PD. RESULTS: Compared with 63 months for geriatric intertrochanteric fracturepatients without PD, patients with PD had a median survival time of 31 months. The Harris Hip Score and Barthel Index of patients with PD were significantly lower than that of patients without PD. In addition, the Depression subscale score of patients with PD were significantly higher that of patients without PD. DISCUSSION: The effect of PD on geriatric patients with intertrochanteric fracture is not the operation itself, but the postoperative rehabilitation. In addition, multi-disciplinary treatment, personal rehabilitation training, more intensive outpatient care, and meticulous nursing were recommended in treatment for elderly patients with intertrochanteric fracture and PD. LEVEL OF EVIDENCE: III, Cohort comparative study.