Assessment of functional abilities of patients with contraindications to operative treatment of femoral neck fractures.
BACKGROUND
Major obstacles to operative treatment of elderly patients with femoral neck fractures frequently encountered in clinical practice include poor overall health, lack of consent to have an operation, and general medical or anaesthesiological contraindications. In such cases, conservative treatment is the only possibility. This aims at maximally improving the patient's functional status, an approach best termed "movement-oriented patient management".


METHODS
The study population consisted of 51 patients (31 F, 20 M) with femoral neck fractures in whom surgery was contraindicated. The patients took part in a movement-oriented management programme. The study consisted in evaluating movement abilities, self-care and locomotion of the patients using the Harris and Lazansky scales. Patients were evaluated twice: at discharge from hospital and at three months after discharge.


RESULTS
In patients assessed using the Lazansky score, Evaluation 1 revealed 88% poor results and 12% satisfactory results, compared to 63% poor results and 37% satisfactory results at evaluation 2. Harris scores did not differ between Evaluations 1 and 2, with 100% of the patients achieving the lowest scores.


CONCLUSIONS
1) The study population of patients with femoral neck fractures in whom surgery was contraindicated did not demonstrate a definite improvement or deterioration of their functional status following "movement-oriented management"; 2) "movement-oriented management" cannot be regarded as having any effect on change in functional status, which should therefore be improved using a more beneficial method of treatment.
Konieczny
Grzegorz
G
Department of Physiotherapy for Locomotor Dysfunction, University of Physical Education, Wrocław.
Wrzosek
Zdzisława
Z
Koprowski
Piotr
P
D000203:Activities of Daily Living; D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D000075202:Contraindications; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005265:Femoral Neck Fractures / Q000628:therapy*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome