Efficacy Study of Multidisciplinary Team Participating in the Perioperative Administration for Elderly Patients With Intertrochanteric Fractures: A Prospective Randomized Controlled Trail.

ABSTRACT

OBJECTIVE: To evaluate the efficacy of the multidisciplinary team (MDT) participating in the perioperative administration and 1-year follow-up for elderly patients with intertrochanteric fractures. METHOD: Elderly patients who underwent surgical treatment of intertrochanteric fractures in our hospital, from January 2018 to December 2020, were taken as the research object. According to the inclusion and exclusion criteria, a total of 76 patients were prospectively included and equally allocated to form a MDT group and a conventional group in this trial by the random number table method. The MDT was composed of doctors from nine disciplines, who would work jointly to evaluate the perioperative risk and formulate the treatment plan and the rehabilitation program. RESULTS: Compared with the conventional group, the time before weight-bearing (59.93 ± 5.93 days vs 67.93 ± 5.87 days), fracture healing time (68.98 ± 7.82 days vs 78.91 ± 7.09 days), and the length of hospital stay (10.43 ± 2.01 days vs 13.87 ± 2.13 days) in the MDT group were all shorter, P < 0.001, and the VAS declined from 3.18 ± 0.81 to 2.28 ± 0.87 at 3 days after the operation and from 0.26 ± 0.04 to 0.23 ± 0.03 at 3 months after the operation in the MDT group, P < 0.001. Compared with the only case in the MDT group which had postoperative complications, postoperative complications were more common in the conventional group, and the difference was statistically significant, P = 0.025. At 1 month and 1 year after the operation, the Harris hip score results of the MDT group were all higher in the seven aspects than those in the conventional group; the difference was statistically significant ( P < 0.001). CONCLUSION: The MDT participated in the perioperative management and the guidance of postoperative rehabilitation of elderly patients with intertrochanteric fractures can markedly improve perioperative symptoms, promote postoperative recovery, and improve long-term hip joint function.