The impact of manual lymphatic drainage on postoperative inflammatory-stress response and functional recovery in elderly hip fracture patients

BACKGROUND: Hip fractures represent a critical health burden among the elderly, necessitating effective rehabilitation strategies beyond conventional therapies. OBJECTIVE: This study aimed to evaluate the efficacy of integrating manual lymphatic drainage (MLD) with conventional therapy (CT) in enhancing functional recovery and reducing inflammation in postoperative hip fracture patients. METHODS: A total of 201 patients were grouped according to the treatment they received, with 96 in the MLD + CT group and 105 in the CT alone group. Key metrics such as muscle strength, walking distance, body function scores, Harris Hip Score (HHS), and activities of daily living were assessed at baseline and 30 days post-treatment. Muscle strength was additionally assessed on the 7th day. RESULTS: Post-intervention, the MLD + CT group showed significant reductions in inflammatory markers compared to the CT group: IL-6 (9.56 ± 1.46 vs. 10.03 ± 1.68 pg/mL, P = 0.036) and HSP70 (1.78 ± 0.34 vs. 1.91 ± 0.37 ng/mL, P = 0.014). Functional recovery was also significantly improved, gastrocnemius strength increased by Day 7 (278.63 ± 21.58 vs. 272.19 ± 23.13 N, P = 0.043), 6-min walk test distance by Day 30 (458.92 ± 48.87 vs. 440.65 ± 50.42 m, P = 0.010), and the HHS total score (73.10 ± 11.84 vs. 68.53 ± 12.24, P = 0.008). Additionally, the Barthel Index revealed higher complete independence rates in the MLD + CT group, with more patients achieving complete independence (15.62% vs. 6.67%, P = 0.042). CONCLUSION: The MLD + CT group demonstrated significant reductions in inflammatory markers and stress markers at 30 days post-surgery, no significant intergroup differences were observed in neurotrauma markers, accelerated functional restoration in geriatric hip fracture recovery, highlighting its potential as an adjuvant therapy for enhanced patient outcomes.