Joonas Mm Kuorikoski1, Tim P Söderlund2. 1. Trauma unit, Department of Orthopaedics and Traumatology, Töölö Hospital, Helsinki, Finland; Academic Medical Centre Helsinki, Helsinki, Finland. 2. Trauma unit, Department of Orthopaedics and Traumatology, Töölö Hospital, Helsinki, Finland; Academic Medical Centre Helsinki, Helsinki, Finland. Electronic address: tim.soderlund@helsinki.fi.
Abstract
BACKGROUND AND PURPOSE: Post-operative follow-up after internal fixation of fractures is a common practice. The goal of this study was to evaluate the necessity of a routine follow-up visit after internal fixation of a proximal femoral fracture. Our hypothesis is that these follow-up visits do not result in a change in the treatment plan, but add an extra cost to the health care system and lead to the purposeless utilisation of limited resources. PATIENTS AND METHODS: A retrospective study of 428 consecutive patients (431 fractures) with a scheduled outpatient clinic visit after internal fixation of proximal femoral fractures in a single hospital during years 2012-2013. We noted any changes in the patients' treatment plans based on the first follow-up visits, including scheduled visits up to ten weeks after internal fixation. RESULTS: None of the patients showed signs of infection, implant failure or loss of reduction requiring re-operation at the scheduled follow-up visit. In only one (0.23%) visit a change in treatment plan was made as a result of the scheduled follow-up visit (decision to remove the distal screws from the long intramedullary nail to obtain dynamic compression). Scheduled visits did not occur for the following reasons, death (11.8%), visit to emergency department prior scheduled visit (3.2%), and not known (3.9%). CONCLUSIONS: The first scheduled visit within ten weeks after internal fixation of a proximal femoral fracture leads to no changes in treatment. We recommend considering the need of these follow-up visits.
BACKGROUND AND PURPOSE: Post-operative follow-up after internal fixation of fractures is a common practice. The goal of this study was to evaluate the necessity of a routine follow-up visit after internal fixation of a proximal femoral fracture. Our hypothesis is that these follow-up visits do not result in a change in the treatment plan, but add an extra cost to the health care system and lead to the purposeless utilisation of limited resources. PATIENTS AND METHODS: A retrospective study of 428 consecutive patients (431 fractures) with a scheduled outpatient clinic visit after internal fixation of proximal femoral fractures in a single hospital during years 2012-2013. We noted any changes in the patients' treatment plans based on the first follow-up visits, including scheduled visits up to ten weeks after internal fixation. RESULTS: None of the patients showed signs of infection, implant failure or loss of reduction requiring re-operation at the scheduled follow-up visit. In only one (0.23%) visit a change in treatment plan was made as a result of the scheduled follow-up visit (decision to remove the distal screws from the long intramedullary nail to obtain dynamic compression). Scheduled visits did not occur for the following reasons, death (11.8%), visit to emergency department prior scheduled visit (3.2%), and not known (3.9%). CONCLUSIONS: The first scheduled visit within ten weeks after internal fixation of a proximal femoral fracture leads to no changes in treatment. We recommend considering the need of these follow-up visits.
Authors: Abhishek Ganta; Nicket Dedhia; Rachel A Ranson; Jonathan Robitsek; Joseph R Hsu; Sanjit R Konda; Kenneth A Egol Journal: Geriatr Orthop Surg Rehabil Date: 2021-02-14
Authors: Michael S Reich; Julie A Switzer; Andrew Sibley; Lisa K Schroder; Sandy Vang; Mai P Nguyen Journal: J Am Acad Orthop Surg Glob Res Rev Date: 2021-06-02