Complications in trochanteric hip fracture surgery

Research output: ThesisDoctoral ThesisCollection of Articles

Abstract

Hip fractures are among the most common operatively treated fractures, and virtually all hip fractures are treated operatively, due to the increase of mortality and the decrease of mobility that is associated with non-operative treatment. One-third to one-half of hip fractures are trochanteric fractures. Most patients are frail and elderly. These fractures lead to increase in mortality, morbidity, loss of independence and mobility as well as notable costs for society. Intramedullary fixation has become the most popular treatment method for trochanteric fractures despite only poor to moderate supporting evidence. A single-centre retrospective analysis of 995 consecutive operatively treated trochanteric fractures with intramedullary fixation was conducted. All patients were followed up on via patient registers for a minimum of two years, and all appointments and operations related to the original fracture operations were recorded to find out rates of post-operative complications, their risk factors and the utility of routine post-operative follow-ups. In this study, we showed that routine post-operative follow-ups led to a change in treatment plan for only 0.9% of the patients. Our suggestion is to replace routine post-operative follow-ups with good instructions that specify in which situations patients should contact the hospital during the healing process. The total rate of surgical site infections was 2.8%, and the rate of deep surgical site infections was 1.5%. Compared to earlier reports, mortality did not increase amongst the patients with a post-operative infection. This supports the use of an implant-retaining treatment protocol. The safety of intramedullary fixation of trochanteric fractures by unattended residents was confirmed by the fact that there were fewer revision surgeries in the group operated by residents compared to that of consultants (5.5% vs. 8.8%, p
Original languageEnglish
Supervisors/Advisors
  • Kosola, Jussi, Supervisor
  • Stenroos, Antti Joonas, Supervisor
Place of PublicationHelsinki
Publisher
Print ISBNs978-951-51-8080-3
Electronic ISBNs978-951-51-8081-0
Publication statusPublished - 2022
MoE publication typeG5 Doctoral dissertation (article)

Bibliographical note

M1 - 81 s. + liitteet

Fields of Science

  • Hip Fractures
  • +surgery
  • Fracture Fixation, Intramedullary
  • Periprosthetic Fractures
  • Reoperation
  • Bone Nails
  • Postoperative Complications
  • Surgical Wound Infection
  • Risk Factors
  • Treatment Outcome
  • Patient Care Planning
  • Patient Education as Topic
  • Professional Competence
  • Physicians
  • Specialization
  • 3126 Surgery, anesthesiology, intensive care, radiology

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