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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Orthop+Traumatol
2017 ; 18
(2
): 107-110
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Should hospital managers read the orthopedic literature before surgeons? The
example of femur fracture management
#MMPMID27538591
Aprato A
; Longo D
; Giachino M
; Agati G
; Massè A
J Orthop Traumatol
2017[Jun]; 18
(2
): 107-110
PMID27538591
show ga
BACKGROUND: Early surgical intervention in the treatment of proximal femur
fractures has been shown to significantly reduce mortality and complications. Our
study intends to evaluate early surgery rates in a single-center analysis before
the clinical advantages of early surgical intervention were demonstrated in the
literature (G1), after the orthopedic team aimed to treat those fractures within
48 h (G2), and after early intervention became a primary objective for hospital
management (G3). MATERIALS AND METHODS: The hospital charts of 894 proximal femur
fractures in patients aged >65 years between 2008 and 2015 were analyzed in a
single teaching hospital. The patients were allocated to three groups according
to admission date, relative to the introduction of the different targets for
early intervention. Our primary aim was to evaluate the differences in the rate
of surgical treatment within 48 h in the three groups, and our secondary aim was
to see if those differences influenced clinical outcomes. RESULTS: The rate of
treatment before 48 h was 23, 49 and 72 % in groups 1, 2 and 3, respectively
(p < 0.001). There were no statistically significant differences between the
three groups regarding time from surgery to discharge and perioperative
mortality. The length of hospitalization was different only between groups 1 and
2. CONCLUSIONS: The adoption of an early treatment goal for proximal femur
fractures by the orthopedic team significantly improved the results. However, it
was only by introducing this goal into primary hospital management objectives
that significantly increased the performance. Level of evidence Level IV
(retrospective case-control study).