Authors (including presenting author) :
Yung BPK(1), Lee SKW(1), Chui TKH(2), Tiu KL(2), Lee KB(2), Chan ACM(1)
Affiliation :
(1)Physiotherapy Department, Queen Elizabeth Hospital
(2)Department of the Orthopaedic and Traumatology, Queen Elizabeth Hospital
Introduction :
Fragility fracture is a fracture resulting from a fall from standing height or less and most commonly occurs at hip, spine, shoulder and wrist. Among these fractures, hip fracture is a major threat for frail people, which often results in pain and decrease in functional mobility after injury. It is often associated with subsequent readmission and mortality. Therefore, intensive rehabilitation as well as bone health education and fall prevention are crucial to improve functional outcomes and prevent secondary fragility fracture for patients after fragility hip fracture. Pioneer Orthopaedic Day Rehabilitation Service (ODRS) for patients after fragility fractures in Queen Elizabeth Hospital (QEH) was implemented since October 2022. The aims are to maximize functional recovery of patients after fragility fracture, prevent secondary fragility fracture; and shorten the hospital length of stay through early supported discharge. It involves a coordinated multidisciplinary team including orthopaedic doctors, nurses, physiotherapists, occupational therapists and dietitians. Physiotherapists provide physical assessment, fall risk assessment, fall prevention education and intensive rehabilitation for indicated patients.
Objectives :
The aim of this article was to review the patients’ demographics, functional mobility and fall rate among the patients with fragility hip fracture in the ODRS in QEH.
Methodology :
This is a descriptive retrospective service review. Physiotherapy records of patients with recent fragility hip fracture attending ODRS from October 2022 to Dec 2022 were reviewed and analyzed. Demographic data of patients, functional status in term of Elderly Mobility Scale (EMS) and fall history of recent one year were collected on admission of ODRS.
Result & Outcome :
During the reviewed period, 94 patients with recent fragility hip fracture within 6 months attended ODRS were reviewed. Seventy-seven percent were female (mean age: 81.4 ± 13.2) and 23% were male (mean age: 79.1 ± 10.6). Mean score of EMS at admission to ODRS was 11.7 out of 20, indicating these patients required some assistance in functional mobility. In addition, high percentage of patient i.e. 47.9% reported repeated fall in recent one year. Therefore, intensive rehabilitation and fall prevention were essential to enhance functional mobility and secondary prevention of fracture for these patients. Among the reviewed patients, 36 patients (38.3%) have attended intensive rehabilitation in ODRS. Physical training, fall prevention intervention, secondary prevention educational talk and pain relief were provided according to individuals’ needs. Further study is warranted to evaluate the effectiveness of ODRS for patients with fragility hip fractures.
