How did the treatment modalities effect the kinesiophobia for the treatment of unstable intertrochanteric fractures? Retrospective clinical trial.

Abstract

ABSTRACT How did the treatment modalities effect the kinesiophobia for the treatment of unstable intertrochanteric fractures? Retrospective clinical trial. Objectives: Kinesiophobia is the fear of pain and re-injury resulting from movement. It may occure after surgery and affect functional outcomes and patient comfort. In this study, we compared fixation with proximal femoral nail antirotation (PFNA) and hemiarthroplasty, which are two essential methods in treating geriatric unstable intertrochanteric femur fractures, by performing functional evaluation and kinesiophobia measurement. Patients and Methods: Patients who were treated with PFNA or hemiarthroplasty for AO 31A2 hip fracture in our clinic between January 2017 and May 2019 were retrospectively evaluated. A total of 72 patients (age range 60-89, mean age 75.2 ± 7.7 years) with at least 1 year follow-up were included in the study. Functional evaluation of the patients was done with the Harris Hip Score (HHS), pain evaluation was performed with the Numerical Rating Scale (NRS), and the kinesiophobia measurement was carried out with the Tampa Scale (TSK). Results: The mean TSK scores in the PFNA and hemiarthroplasty groups were 47.9±4.9 (95% CI 46.4-49.5) and 51.7±5.7 (95% CI 49.6-53.4), respectively (p<0.05). On the other hand, while the mean HHS was 89.1±3.7 (95% CI 87.2-90.3) in the PFNA group, it was 86.2±4.1 (95% CI 84.8-87.6) in the hemiarthroplasty group (p<0.05). The NRS score was 2.81±2.62 in the PFNA group and 3.11±2.81 in the hemiarthroplasty group (p=0.672). There was no correlation between age and TSK, NRS, or HHS scores (p=0.316). However, a significant negative correlation was observed between the HHS and TSK scores (r=-0.77, p<0.01). Conclusion: Although hemiarthroplasty allows for early mobilization in geriatric unstable intertrochanteric femur fractures, it is associated with higher kinesiophobia levels. Compared to a hemiarthroplasty, fixation with PFNA is more advantageous regarding functional outcomes and kinesiophobia. Level of evidence: 4, Case-series (and poor-quality cohort and case-control studies)

Keywords

• ıntertrochanteric fractures
• Hemiarthroplasty
• Kinesiophobia and PFNA
• Pain

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