Predictive factors of return to activity in elderly patients operated on for a fracture of the lower limb: a study of 113 patients
DOI:
https://doi.org/10.18203/2349-2902.isj20233332Keywords:
Elderly subject, Return to activity, Lower limbAbstract
Background: The aim of this study was to determine the factors predictive of resumption of activity in elderly subjects operated on for a fracture of the lower limb.
Methods: This was a cross-sectional study with retrospective data collection in subjects aged 56 and over who had undergone lower-limb surgery with a minimum follow-up period of six months. Patients' walking autonomy was assessed using the Parker score. The modular integrated household survey on living conditions was used to assess patients' socio-economic status. Bivariate analysis was performed using the chi-square test and the calculation of measures of association.
Results: The series included 113 patients with a mean age of 70±9.54 years and a sex ratio of 1.09. Fractures of the upper end of the femur predominated in 67.6% of cases. The most common surgical procedure was intermediate hip replacement in 30 patients (26.5%). Rehabilitation sessions were performed in 95 patients (84.1%). The postoperative Parker score at the last follow-up was 9/9 in 41 patients (36.3%). Resumption of educational and productive activities and interpersonal responsibilities was achieved in 90 patients (79%). Significant associations (p<0.05) were found between resumption of activities and age, sex, marital status, history of arterial hypertension, psychiatric history, preoperative Parker score, postoperative Parker score and return to a private residence.
Conclusions: Older age, female gender, absence of a partner, high blood pressure, non-personal residence and poor Parker score are factors with a poor prognosis for return to activity.
References
Pardessus V, Puisieux F. Rééducation-réadaptation du sujet âgé chuteur. Réalités Cardiol. 2013;295:25 32.
Alonso E, Krypciak S, Paillaud E. Rôle de la nutrition dans les chutes et les fractures des sujets âgés: Gerontol Soc. 2010;134(3):171 87.
Pras P, Bouaziz D, Tardieux PM, Bailleux S. Syndrome d’immobilisation : conséquences et stratégies préventives. NPG. 2005;5(27):46 51.
Evano M, Arrigoni S, Rabuel C. Fracture du col du fémur du sujet âgé: comment améliorer le pronostic ? Rev du Rhum Monogr. 2019;86(4):313 7.
Curran D, Maravic M, Kiefer P, Tochon V, Fardellone P. Épidémiologie des fractures liées à l’ostéoporose en France : revue de la littérature. Rev Rhum. 2010;77(6): 579 85.
Biaou A, Makpenon M, Ahovey E, Adechian D, Baco A, Mededji D. Enquête modulaire intégrée sur les conditions de vie des ménages. Available at : https://instad.bj/images/docs/insae-statistiques/ enquetes-recensements/EMICoV/2015/Rapport_ pr%C3%A9liminaire_Emicov_2015.pdf. Accessed on 20 February 2023.
Voeten SC, Nijmeijer WS, Vermeer M, Schipper IB, Hegeman JH, De Klerk G, et al. Validation of the Fracture Mobility Score against the Parker Mobility Score in hip fracture patients. Injury. 2020;51(2): 395 9.
Ganczak M, Chrobrowski K, Korzeń M. Predictors of a change and correlation in activities of daily living after hip fracture in elderly patients in a community hospital in Poland: A Six-month prospective cohort study. IJERPH. 2018;15(1):95.
Kardali C, Rahmi M, Ghrib S, Chraf-Eddine A, Garch A, Rafai M, et al. Les prothèses intermédiaires dans les fractures cervicales vraies récentes (A propos de 49 cas). Rev Maroc Chir Orthop Traumato. 2012;46:32 8.
Wantonoro W, Shyu YIL, Chen ML, Tsai HH, Chen MC, Wu CC. Functional Status in Older Persons After Hip Fracture Surgery: A Longitudinal Study of Indonesian Patients. J Nurs Res. 2022;30(3):e211.
Sydney W, Jo EB. Factors Affecting Postsurgery Hip Fracture Recovery. J Orthopaed Trauma Rehab. 2014; 18(2):54 8.
Cao Y, DiPiro ND, Jarnecke M, Krause JS. Social participation as a mediator of the relationships of socioeconomic factors and longevity after traumatic spinal cord injury. Spinal Cord. 2022;60(9):799 804.
Gomez M, Rony L, Marc C, Talha A, Ruiz N, Noublanche S, et al. Fast-track care for pertrochanteric hip fracture: What impact on function and autonomy after discharge? Orthopaed Traumatol Surg Res. 2020; 106(4):633 7.
Mallick A, Jehan S, Omonbude D. Outcome of surgery in neck of femur fracture patients with poor pre-fracture mobility. HIP Int. 2020;30(6):805 9.
Bouzid S. Activité physique et fonctionnement cognitif chez les personnes agées. Milev J Res. 2021;7(2): 343 56.
Ndiaye N, Sylla A, Touré K, Thiam M, Gueye M. Bilan de fonctionnement d’une Clinique de la mémoire sénégalaise. Afr J Neurol Sci. 2012;30(1):2-9.
Dubuc JE, Cauter MV, Cornu O. Fracture du col fémoral de l’adulte. Available at: https://oer.uclouvain.be/jspui/bitstream/20.500.12279/281/1/Jean-Emile%20Dubuc_Fractures%20du% 20col%20fe%CC%81moral.pdf. Accessed on 20 February 2023.
Capdevila X, Biboulet P, Choquet O. Stratégie de réhabilitation postopératoire de la fracture du col fémoral. Ann Fr Anesth Réanim. 2011;30(10):e55 9.
Lestavel P, Jankowiak G, Leclercq M, Gueriot S. Fractures de la hanche : les problèmes posés à l’urgentiste. Available at: https://www.sfmu.org/ upload/70_formation/02_eformation/02_congres/Urgences/urgences2008/donnees/pdf/078_lestavel.pdf. Accessed on 20 February 2023.
