老人骨折の機能回復

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In the present paper the aged are defined for convenience sake as those who are over 60 years old. In the authors' hospital 2,614 in-patients have undergone the orthopedic functional training, and the aged patients among them are 84 in number (3.2%), 61 cases (73%) of which had fractures. Among fractures in the aged those of the femur predominate, and then come the vertebral and the fibula and tibia fractures. The patients at the age of 65 make up the largest number, and the number of male-patients is twice as large as that of female. As the cause of fractures tumbling predominates, then, falling and blow. After they sustained fractures 23% of the patients retired from their jobs, and 7% changed their jobs. In comparison with the younger patients of fracture the aged patients are naturally slower to develop bony union and consequently the period of plaster fixation, hospitalization, and training is likely to be prolonged. Besides, because of the atrophy of soft tissues during this period the adjacent joints tend to develop contractures easily.Since the aged are generally lacking in active motivation for the functional recovery return to the society and very prone to accidents, it is of importance to watch them closely during the orthopedic functional training, and to give them a positive psychological support, while taking the above tendencies into consideration. At the same time it is necessary to direct them with sympathy and kindness to continue the functional training by themselves regularly without undue overstrains. This should also be taken into consideration in cases of the aged patients. Besides, the treatment of the aged patients who suffer from complications requires the utmost caution. However, through above mentioned cautious treatment and training it is possible for the aged patients to recover their function to a level as high as that of the ordinary patients, though it must be admitted that the level of recovery of the aged is slightly lower as expected. But the question remains in the case that the knee joint contracture is apt to stay on even after the treatment of lower limb fracture, as in the cases of general fractures.The questionaire on pain was sent to 37 patients who had undergone the hospital training. Answers were obtained from 77% of them. Generally speaking, among pains numbness predominates, but the incidence of numbness among the aged patients is lower than that among the ordinary patients. And pain occurs most frequently in cold environment and then at the time of fatigue. The cause of pain is the impediment of blood circulation at the affected part. The incidence of pain caused by the impediment of blood circulation is rather high among the aged. And the means of treatment given by the patients are hot spring bath, massage, and hot compress in order. The questionaire indicates that such heat treatments as hot spring bath and others relax muscle tones at the affected part, relieve nervous excitability and improve circulation, and at the sametime, psychologically give them a peaceful rest. The fact acupuncture and moxacautery are resorted to by some patients is considered co be characteristic of the aged.The questionaire on activities of daily living was sent to 23 patients who had undergone the hospital training (16 of them were judged physically handicapped according to the National Annuity Law), and to 6 patients who had received the indoor training. All these patients suffered from fractures of the lower limb and trunk. It is important to notice that the patients of lower limb fracture comlain-ed mainly of difficulty in walking and kneel sitting. By the examination according to the National Annuity Law quite many patients of fractures are judged physically handicapped, because of their inability to do kneel or crosse legged sitting. in sitting upright or cross legged. This kind of impediment becomes serious for the Japanese who spend their home life on tatami matts. Therefore the problem of t
社団法人日本リハビリテーション医学会の論文

老人骨折の機能回復

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