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4. Reliability of the classification of proximal femur fractures: Does clinical experience matter?

Author

Crijns, Tom J., primary, Janssen, Stein J., additional, Davis, Jacob T., additional, Ring, David, additional, Sanchez, Hugo B., additional, Althausen, Peter, additional, Amini, Michael H., additional, Appleton, Paul, additional, Babis, George C., additional, Babst, Reto H., additional, Ballas, Efstathios G., additional, Barquet, Antonio, additional, Begue, Thierry, additional, Bishop, Julius, additional, Borris, Lars C., additional, Buckley, Richard, additional, Chesser, Tim, additional, Choudhari, Pradeep, additional, Cornell, Charles, additional, Crist, Brett D., additional, DeCoster, Thomas A., additional, Elias, Nelson, additional, Frihagen, Frede, additional, Garnavos, Christos, additional, Giordano, Vincenzo, additional, Haverlag, R., additional, Havlicek, Tomo, additional, Hurwit, Shep, additional, Ibrahim, Edward F., additional, Iyer, Vishwanath M., additional, Jenkinson, Richard, additional, Jeray, Kyle, additional, Kabir, Koroush, additional, Kanakaris, Nikolaos K., additional, Klostermann, Cyrus, additional, Kreder, Hans J., additional, Kreis, B.E., additional, Kristan, Anze, additional, Lygdas, P., additional, McGraw, Iain, additional, Mica, Ladislav, additional, Mirck, B., additional, Moreta-Suarez, Jesus, additional, Morgan, Steven J., additional, Nikolaou, Vassilios S., additional, Omara, Timothy, additional, Pesantez, Rodrigo, additional, Pirpiris, Marinis, additional, Poelhekke, L.M.S.J., additional, Pountos, Ippokratis, additional, Prayson, Michael, additional, Quell, M., additional, Rodríguez-Roiz, Juan M., additional, Satora, Wojciech, additional, Schandelmaier, Peter, additional, Schepers, T., additional, Short, Nicholas L., additional, Smith, Raymond M., additional, Spoor, A.B., additional, Stojkovska Pemovska, Emilija, additional, Swiontkowski, Marc, additional, Taitsman, Lisa, additional, Tosounidis, Theodoros, additional, Tyllianakis, Minos, additional, Van bergen, C.J.A., additional, Van de Sande, M.A.J., additional, Van Helden, S.H., additional, Verbeek, Diederik O., additional, Wascher, Daniel C., additional, and Weil, Yoram, additional

Published
2018
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5. Trauma surgery by general surgeons: Still an option for proximal femoral fractures?

Author

Treskes K, Voeten SC, Tol MC, Zuidema WP, Vermeulen J, Goslings JC, Schep NW, van den Brand JGH, van Velde R, Haverlag R, Ultee JM, Postma VA, Twigt BA, van Dijkman BA, Heres P, Winkelhagen J, Klooster M, and Toor EJ

Subjects
Aged, Aged, 80 and over, Female, Femoral Fractures epidemiology, General Surgery, Humans, Male, Netherlands epidemiology, Orthopedic Procedures, Patient Selection, Postoperative Complications, Trauma Severity Indices, Treatment Outcome, Clinical Competence standards, Femoral Fractures surgery, Fracture Fixation, Internal methods, Fracture Fixation, Internal standards, Reoperation statistics & numerical data, Surgeons, Surgical Wound Infection epidemiology
Abstract

Introduction: Surgery for proximal femoral fractures in the Netherlands is performed by trauma surgeons, general surgeons and orthopaedic surgeons. The aim of this study was to assess whether there is a difference in outcome for patients with proximal femoral fractures operated by trauma surgeons versus general surgeons. Secondly, the relation between hospital and surgeon volume and postoperative complications was explored., Methods: Patients of 18 years and older were included if operated for a proximal femoral fracture by a trauma surgeon or a general surgeon in two academic, eight teaching and two non-teaching hospitals in the Netherlands from January 2010 until December 2013. The combined endpoint was defined as reoperation or surgical site infection. Multivariate analysis was used to adjust for patient and fracture characteristics and hospital and surgeon volume. Categories for hospital volume were>170/year (high volume), 96-170/year (medium volume) and <96/year (low volume)., Results: In 4552 included patients 2382 (52.3%) had surgery by a trauma surgeon. Postoperative complications occurred in 276 (11.6%) patients operated by a trauma surgeon and in 258 (11.9%) operated by a general surgeon (p=0.751). When considering confounders in a multivariate analysis, surgery by trauma surgeons was associated with less postoperative complications (OR 0.746; 95%CI 0.580-0.958; p=0.022). Surgery in high volume hospitals was also associated with less complications (OR 0.997; 95%CI 0.995-0.999; p=0.012). Surgeon volume was not associated with complications (OR 1.008; 95%CI 0.997-1.018; p=0.175)., Conclusion: Surgery by trauma surgeons and high hospital volume are associated with less reoperations and surgical site infections for patients with proximal femoral fractures., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Published
2017
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