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The effect of delay to surgery on morbidity, mortality and length of stay following periprosthetic fracture around the hip

Lookup NU author(s): Sarah Johnson-Lynn, Paul Fearon

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Abstract

With the increasing prevalence of total hip arthroplasty and the increasing longevity of patients with implants in situ, periprosthetic fractures of the proximal femur are seen with greater frequency. They represent a challenging surgical problem, requiring combined arthroplasty and trauma skills in a potentially compromised surgical bed. We present data from the 82 consecutive patients with periprosthetic fractures around the hip presenting to two NHS Foundation Trusts in the period January 2009 to February 2014.Inpatient mortality across all sites was 11.0%. This increased to 17.1% at 1 year. There was no association between delay to surgery and either inpatient or 1 year mortality. Mean delay to surgery was 4.1 days in those without inpatient mortality, 5.2 days in those with (p = 0.3075). Mean delay to surgery was 4.5 days in those with 1 year mortality, 4.16 days in those without (p = 0.6203). The number of postoperative complications was not significantly positively correlated with increasing delay to surgery (Pearson correlation coefficient 0.04437).It would appear that a delay to order necessary equipment and obtain relevant surgical expertise for the treatment of these complex fractures is safe and not associated with increased mortality or postoperative complications. (C) 2015 Elsevier Ltd. All rights reserved.


Publication metadata

Author(s): Johnson-Lynn S, Ngu A, Holland J, Carluke I, Fearon P

Publication type: Article

Publication status: Published

Journal: Injury

Year: 2016

Volume: 47

Issue: 3

Pages: 725-727

Print publication date: 01/03/2016

Online publication date: 21/11/2015

Acceptance date: 10/11/2015

ISSN (print): 0020-1383

ISSN (electronic): 1879-0267

Publisher: Elsevier

URL: http://dx.doi.org/10.1016/j.injury.2015.11.013

DOI: 10.1016/j.injury.2015.11.013


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