Takahashi Mitsuhiko, Iwase Joji, Abe Mitsunobu, Hashimoto Naoko, Kosaka Hirofumi, Egawa Hiroshi
Department of Orthopedic Surgery, Tokushima Prefectural Central Hospital, Kuramoto, Japan.
Department of Psychiatry, Tokushima Prefectural Central Hospital, Kuramoto, Japan.
JMA J. 2020 Jul 15;3(3):265-271. doi: 10.31662/jmaj.2019-0055. Epub 2020 Jul 8.
Though a combination of proximal femoral fracture and mental illness is likely, the management of this combination is not well established. The aim of this study was to clarify the current disposition of acute care and rehabilitation for patients with this combination of conditions at our institution.
We retrospectively analyzed the records of 192 patients hospitalized in the psychiatric ward who present with a proximal femoral fracture and an antecedent mental illness. We investigated walking ability prior to injury and after surgery, at discharge from our institution, using the Functional Independence Measure (FIM) score.
Although patients in the psychiatric ward demonstrated postoperative hospital stays approximately 10 days longer than those in the orthopedic ward, more than half of the patients in the psychiatric ward were discharged from our institution with a functional level of complete dependence for walking ability. In addition, nearly 90% of the patients studied were transferred to a psychiatric hospital where no physical therapy or rehabilitation was provided to the inpatients.
At our institution, patients with proximal femoral fracture and antecedent mental illness tended to be discharged with complete dependence in walking ability, often to a psychiatric hospital without physical therapy or rehabilitation. We hope this paper will draw attention to the need for rehabilitation in these patients.
虽然股骨近端骨折与精神疾病同时存在的情况很可能发生，但针对这种合并情况的治疗方法尚未完全确立。本研究的目的是阐明我院针对患有此类合并病症患者的急性护理和康复的当前处置方式。
我们回顾性分析了192例因股骨近端骨折和既往精神疾病而入住精神科病房的患者的记录。我们使用功能独立性测量（FIM）评分调查了患者受伤前、手术后以及从我院出院时的行走能力。
尽管精神科病房的患者术后住院时间比骨科病房的患者长约10天，但精神科病房超过一半的患者出院时在行走能力方面处于完全依赖的功能水平。此外，近90%的研究患者被转至一家未为住院患者提供物理治疗或康复服务的精神病医院。
在我院，患有股骨近端骨折和既往精神疾病的患者往往在行走能力方面处于完全依赖的状态出院，且常常被转至一家没有物理治疗或康复服务的精神病医院。我们希望本文能引起人们对这些患者康复需求的关注。
