OBJECTIVES: Reoperations are common after surgical treatment of hip fractures but may be reduced by optimal choice of implant based on fracture classification. We hypothesized that implementing a surgical treatment algorithm was possible in our hospital and would result in a reduced reoperation rate. DESIGN: Retrospective comparative study. SETTING: Provincial level III trauma center. PATIENTS: The evidence-based "Hvidovre Algorithm" for treatment of hip fractures was adopted and implemented at our provincial institution in September 2008. Three hundred eighty-six consecutive patients older than 50 years admitted with a hip fracture in the first year after implementation were prospectively included and compared with 417 retrospectively included similar patients admitted within the last year before implementation. INTERVENTION: Implementation of an evidence-based treatment algorithm for hip fracture surgery. RESULTS: Eighty-five percent (330 of 386) patients were operated according to the algorithm after implementation, compared with 67% (280 of 417) of procedures before implementation (P < 0.001). After implementation, the overall reoperation rate showed a tendency toward a reduction to 8% (32 of 386) from 12% (48 of 417) (P = 0.1). Among all the 803 included patients, the reoperation rate was lower if procedures had been performed according to the algorithm recommendations: 9% (53 of 610) versus 14% (27 of 193) (P = 0.009). CONCLUSIONS: The algorithm for hip fracture surgery was easily implemented, and our results support that using it facilitates a low reoperation rate. The reoperation rate may be further reduced with higher adherence to algorithm recommendation. LEVEL OF EVIDENCE: Therapeutic level III. See instructions for authors for a complete description of levels of evidence.
OBJECTIVES: Reoperations are common after surgical treatment of hip fractures but may be reduced by optimal choice of implant based on fracture classification. We hypothesized that implementing a surgical treatment algorithm was possible in our hospital and would result in a reduced reoperation rate. DESIGN: Retrospective comparative study. SETTING: Provincial level III trauma center. PATIENTS: The evidence-based "Hvidovre Algorithm" for treatment of hip fractures was adopted and implemented at our provincial institution in September 2008. Three hundred eighty-six consecutive patients older than 50 years admitted with a hip fracture in the first year after implementation were prospectively included and compared with 417 retrospectively included similar patients admitted within the last year before implementation. INTERVENTION: Implementation of an evidence-based treatment algorithm for hip fracture surgery. RESULTS: Eighty-five percent (330 of 386) patients were operated according to the algorithm after implementation, compared with 67% (280 of 417) of procedures before implementation (P < 0.001). After implementation, the overall reoperation rate showed a tendency toward a reduction to 8% (32 of 386) from 12% (48 of 417) (P = 0.1). Among all the 803 included patients, the reoperation rate was lower if procedures had been performed according to the algorithm recommendations: 9% (53 of 610) versus 14% (27 of 193) (P = 0.009). CONCLUSIONS: The algorithm for hip fracture surgery was easily implemented, and our results support that using it facilitates a low reoperation rate. The reoperation rate may be further reduced with higher adherence to algorithm recommendation. LEVEL OF EVIDENCE: Therapeutic level III. See instructions for authors for a complete description of levels of evidence.
Authors: Katie J Sheehan; Boris Sobolev; Pierre Guy; Lisa Kuramoto; Suzanne N Morin; Jason M Sutherland; Lauren Beaupre; Donald Griesdale; Michael Dunbar; Eric Bohm; Edward Harvey Journal: CMAJ Date: 2016-10-17 Impact factor: 8.262
Authors: Carl Erik Alm; Frede Frihagen; Eva Dybvik; Kjell Matre; Jan Erik Madsen; Jan-Erik Gjertsen Journal: J Orthop Surg Res Date: 2021-01-07 Impact factor: 2.359