FEATURES OF REHABILITATIVE TREATMENT OF ELDERLY PATIENTS AFTER FRACTURES OF THE PROXIMAL FEMUR: ANALYSIS OF METHODS AND APPROACHES

Backgraund : Proximal femur fractures are a serious medical problem, especially among elderly patients. Aims : This study aims to compare the effectiveness of various rehabilitative treatments among elderly patients with proximal femur fractures. Materials and methods : The research was conducted between 2022 and 2023 at the state autonomous healthcare institution “City Clinical Hospital No. 7 named after M.N. Sadykov” (Kazan, Russia). The study included 150 patients randomised to four groups. Group 1: patients after osteosynthesis with restorative treatment (n = 37), Group 2: patients after osteosynthesis without restorative treatment (n = 38), Group 3: patients after endoprosthesis with restorative treatment (n = 38), Group 4: patients after endoprosthesis without restorative treatment (n = 37). Rehabilitation treatment included physical therapy (PT) and physiotherapy. All patients received basic medical therapy, including non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics. Statistical analysis: Descriptive statistics, analysis of variance (ANOVA) to compare groups, and regression analysis were used to identify factors influencing treatment outcomes. Assessments were made pre-operatively, post-discharge and 3 months later using visual analogue scale (VAS), Harris pain scale, SF-36 quality of life scale and Rivermead pain scale. Results : The mean pain scores (VAS) at baseline were 8.0±0.5 (group 1), 7.9±0.4 (group 2), 7.8±0.3 (group 3) and 7.7±0.4 (group 4). After one month of treatment, the values decreased to 3.9±0.3, 5.4±0.4, 4.1±0.3 and 5.8±0.5, respectively. After three months, the values were 1.5±0.2, 3.7±0.3, 1.8±0.2 and 4.2±0.4, respectively. The analysis showed a significant improvement in patients who received restorative treatment compared to those who did not receive restorative treatment (p < 0.001). Conclusions: Our study confirmed a significant improvement in outcome in patients with proximal femoral fractures treated with surgery combined with physiotherapy and exercise. These data are important for developing clinical recommendations and optimizing standards of care for this group of patients.