Abstract | BACKGROUND: Hip fracture patients experience high pain levels during postoperative rehabilitation. The role of surgical technique on postoperative pain has not been evaluated previously. METHODS: One hundred and seventeen hip fracture patients were included in a descriptive prospective study. All patients received continuous epidural analgesia and were treated according to a standardized perioperative rehabilitation programme. Resting pain, pain on hip flexion, and walking were measured during daily physiotherapy sessions on a verbal five-point rating scale during the first four postoperative days. Patients were stratified into four groups according to surgical procedure: screws or pins, arthroplasty, dynamic hip screw (DHS), and intra-medullary hip screw (IMHS). RESULTS: Cumulated pain levels were significantly different between surgical procedures both for hip flexion (P=0.002) and for walking (P=0.02) with highest dynamic pain levels for patients who had either DHSs or IMHSs compared with arthroplasty or parallel implants. There were significant negative correlations between ambulatory capacity assessed by the cumulated ambulation score and both the dynamic cumulated pain scores on hip flexion (r=-0.43, P<0.001) and walking (r=-0.36, P=0.004). CONCLUSIONS:
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Authors | N B Foss, M T Kristensen, H Palm, H Kehlet |
Journal | British journal of anaesthesia
(Br J Anaesth)
Vol. 102
Issue 1
Pg. 111-6
(Jan 2009)
ISSN: 1471-6771 [Electronic] England |
PMID | 19059921
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Analgesia, Epidural
(methods)
- Arthroplasty, Replacement, Hip
(rehabilitation)
- Bone Nails
- Bone Screws
- Female
- Fracture Fixation, Internal
(instrumentation, methods, rehabilitation)
- Fracture Fixation, Intramedullary
(rehabilitation)
- Hip Fractures
(rehabilitation, surgery)
- Humans
- Male
- Middle Aged
- Pain Measurement
(methods)
- Pain, Postoperative
(etiology)
- Physical Therapy Modalities
(adverse effects)
- Prospective Studies
- Walking
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