Functional ability before and after rehabilitation in elderly patients with shortening and/or rotational deformity of the lower limb after hip fracture.

BACKGROUND

Shortening and rotational deformity of the lower limb (SRD) is a major complication of hip fracture surgery. It causes not only hip joint dysfunction but also functional impairments due to abnormal gait parameters, decreased gait velocity, and poor balance. Despite a number of previous studies, the effect of SRD on the postsurgical recovery of these patients is still not clear.

OBJECTIVE

To compare the functional abilities and balance before and after rehabilitation for people with and without SRD after hip fracture surgery and to assess whether SRD affects rehabilitation.

DESIGN

Prospective observational study.

SETTING

Inpatients of a rehabilitation unit.

PARTICIPANTS

A total of 102 people with hip fracture (62 without SRD and 40 with SRD at the time of admission to the unit).

MAIN OUTCOME MEASURES

Berg Balance Scale (BBS) and Functional Independence Measure (FIM) motor score, administered before and after rehabilitation.

INTERVENTIONS

Motor rehabilitation.

RESULTS

Before rehabilitation, patients with SRD had lower motor-FIM (p = .002) and BBS (p = .001) scores than those without SRD. After rehabilitation, both groups showed similar improvements in motor-FIM, BBS, range of motion, muscle strength, and pain scores (p < .001, for all), but patients with SRD still had lower motor-FIM and BBS scores (p = .014 and .003, respectively) and lower effectiveness in motor-FIM and BBS (p = .039 and p = .034, respectively) than those without SRD.

CONCLUSIONS

SRD is associated with lower levels of balance and functional abilities before and after rehabilitation and it adversely affects rehabilitation for patients with hip fractures.