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No Need For Rehab Program Based on Type of Hip Fracture

Posted on: 11/30/1999
Getting back on your feet after a hip fracture can be a challenge. Many older adults with a hip fracture never do return to their former walking abilities. Early surgery and rehab may help. Muscle strength training is often the focus of the rehab program.

In this study, doctors from Japan compared the muscle size of patients' upper legs after two different types of hip fractures. Half the patients had a femoral neck fracture. The other half had an intertrochanteric fracture of the femur (thigh bone). All patients had surgery to repair the fracture.

The idea was to gear the rehab program specifically to the weak and atrophied (wasted) muscles. But comparing the walking ability to CT scans of the thigh muscles did not show any relationship between muscle atrophy and walking ability. Scans were taken before surgery (at the time of hospital admission) and after surgery (one month later).

There was significant muscle atrophy on both sides (fractured side and uninvolved side). The authors suspect some other factors are more important than muscle atrophy and fracture type. A rehab exercise program specifically based on the type of fracture isn't needed.

At least this was true for the first month post-op. The authors suggest further long-term studies are needed to know if muscle atrophy matched with fracture type is more important later in the recovery process.

They also looked at age, pain, nutritional status, and the presence of other health problems as possible reasons for decline in walking ability. These preinjury variables appear to be more likely to predict a patient's ability to walk after hip surgery for a fracture. They should be studied more closely.

Rehab after hip fracture is still very important. Patients who exercise and get back to activity sooner than later have a better outcome. The search for just the right rehab program after hip fracture will continue.

Hiroyasu Ogawa, MD, et al. Analysis of Muscle Atrophy After Hip Fracture in the Elderly. In Archives of Physical Medicine and Rehabiliation. February 2008. Vol. 89. No. 2. Pp. 329-332.

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