Comparison of daytime and after-hours surgical treatment of femoral neck fractures

Abstract

Background: The timing of surgery for femoral neck fractures in young adults remains controversial. Nonetheless, the debate continues about whether orthopedic trauma cases should be operated daytime or after hours. Aim: This study compared the clinical and radiological outcomes of surgery on femoral neck fractures during daytime versus after-hours. Patients and Methods: A total of 124 patients aged 18–60 years who were operated for femoral neck fractures between 2015 and 2020 were included in the study. The patients were separated into two groups. Seventy-two patients operated between 08:00 and 17:00 hours were defined as the daytime group and 52 patients operated between 17:01 and 07:59 hours were defined as the after-hours group. Demographic data, reduction quality, duration of operation, intraoperative estimated blood loss (EBL), postoperative complications, revision rates, and postoperative Harris hip score results of the two groups were recorded for analysis. Results: There was no significant difference between the groups in terms of age, gender, body mass index, smoking, fracture type and follow-up time, reduction quality, postoperative complication rates, revision rates, and Harris hip score results. Waiting times until surgery, operation duration, and intraoperative EBL amounts were, in the daytime group, significantly higher than in the after-hours group. Conclusion: In this study comparing femoral neck fractures operated on daytime and after-hours in adults, the waiting time until surgery was found to be higher in the daytime group. Operation duration and EBL were higher in the after-hours group.

Comparison of Posterior and Anterolateral Surgical Approaches in Treating Adult Humeral Shaft Fractures

“…The Mayo elbow performance score is a widely used scoring system to evaluate elbow function after surgical treatment of humeral shaft fractures [22]. According to a study by Li et al, they did not find a significant difference between patients who underwent posterior and anterolateral approaches [16]. In our study, elbow ROM limitation was higher in patients who underwent a posterior approach, and the Mayo score was lower, but it was not significant.…”

“…The use of functional braces in the conservative treatment of humeral mid-shaft fractures can provide excellent clinical outcomes; however, this treatment is associated with various complications, including a high rate of nonunion, which can occur in up to 15% of cases [15]. Surgeons often prefer surgery as a treatment for mid-shaft fractures due to the possibility of a faster recovery of function [16]. Compared to ORIF, the intramedullary nailing technique involves more significant risks of limited shoulder movement and fixation failure.…”