Time intervals in the treatment of fractured femurs as indicators of the quality of trauma systems

Matityahu, Amir; Elliott, Iain S.; Marmor, Meir T.; Caldwell, Amber; Coughlin, Richard; Gosselin, Richard A.

doi:10.2471/blt.13.120436

Cited by 17 publications

(16 citation statements)

References 36 publications

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“…The result of our study showed preponderance of male gender (89.4%) and young age (mean 30 years) which is in line but with a slightly lower mean age in comparison to an earlier study from Saudi Arabia (33 years) [18]. In contrast, Khan et al [3] reported higher proportion of females (58%) and advanced age (mean 63 yeras) among distal femoral shaft fractures treated at a tertiary referral hospital in London. An earlier study from Saudia Arabia reported that half of femur fracture victims belongs to age group of 16 to <30 years followed by 30 to <60 years (39.3%) [18].…”

Section: Discussionsupporting

confidence: 78%

“…Femur is the most commonly fractured long bone in the body which often necessitates surgical xation [2]. Femoral shaft fractures have bimodal distribution across age groups with high velocity injuries that are more common among adult males while low energy injuries tend be more common in children and elderly females [3]. The most commonly injured site of femur is the midshaft particularly among adults population following road tra c accidents [4].…”

Section: Introductionmentioning

confidence: 99%

“…There are various treatment options for femur xation such as conservative management, xation with screw and plate, intramedullary nailing, open reduction and internal xation, external xation and total knee replacement [3]. Diaphyseal femur fractures are preferably treated with intramedullary nailing which helps to attain appropriate bone alignment, quicker bone healing that allows early mobilization and lower rate of complications [14].…”

Section: Introductionmentioning

confidence: 99%

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Descriptive Analysis Of Femur Fracture Patterns, Management And Outcome: Descriptive Observational Study From A Level 1 Trauma Center

Ghouri

Asim

Mustafa

et al. 2020

Preprint

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Background We aimed to assess the patterns, associated injuries, management and outcome of traumatic femoral fractures.Methods This retrospective study was conducted to include all trauma patients with femoral shaft fractures admitted in a level 1 trauma center between January 2012 and December 2015. Data were analyzed and compared according to the time to intramedullary nailing; mechanisms of injury and age groups.Results A total of 605 cases were analyzed, with mean age of 30.7±16.2 years.The majority of fractures were unilateral (96.7%) and 91% were closed fractures. Three-fourth of fractures were treated by reamed intramedullary nailing (rIMN); antegrade in 80%. The pyriform fossa nails were used in 71.6% while trochanteric entry nails was used in 28.4%. Forty five (8.9%) of fractures were treated with external fixator, 37 (6.1%) had conservative management. Victims of traffic-related accidents were younger, sustained severe injuries, and more likely to have rIMN and required more blood transfusion. Traffic-related injuries occured more in patients aged 14-30 years whereas; injuries related to fall were significantly higher in patients aged 31-59 years. Thirty-one patients (7.8%) had rIMN < 0-6 h, 106 (25.5%) had rIMN < 6-12 h and 267 (66.8%) had rIMN > 12 h. The implant type, duration of surgery, DVT prophylaxis, in-hospital complications and mortality were comparable among the three treatment groups.Conclusions the frequency of femoral fracture is 11% mainly in severely injured young males by traffic-related accidents and falls. Further multicenter studies are needed.

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Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Descriptive Analysis Of Femur Fracture Patterns, Management And Outcome: Descriptive Observational Study From A Level 1 Trauma Center

Ghouri

Asim

Mustafa

et al. 2020

Preprint

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“…For example, length of acute care stay was measured from time to ward admission to discharge as well as from time to emergency department presentation to discharge. 45 46 Definitions of time to surgery also varied, as some studies defined time to surgery as the time from medical stability to surgery; 47 48 some studies defined time to surgery as time from admission to surgery, [48][49][50][51][52][53][54][55] and others created a binary variable for time to surgery (eg, had surgery within 24 hours). [56][57][58][59] The one exception was the UK's Best Practice Tariff indicators, which are clearly defined across studies.…”

Section: Indicators or Potential Indicators By Study Settingmentioning

confidence: 99%

Scoping review of potential quality indicators for hip fracture patient care

et al. 2017

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ObjectiveThe purpose of this study is to identify existing or potential quality of care indicators (ie, current indicators as well as process and outcome measures) in the acute or postacute period, or across the continuum of care for older adults with hip fracture.DesignScoping review.SettingAll care settings.Search strategyEnglish peer-reviewed studies published from January 2000 to January 2016 were included. Literature search strategies were developed, and the search was peer-reviewed. Two reviewers independently piloted all forms, and all articles were screened in duplicate.ResultsThe search yielded 2729 unique articles, of which 302 articles were included (11.1%). When indicators (eg, in-hospital mortality, acute care length of stay) and potential indicators (eg, comorbidities developed in hospital, walking ability) were grouped by the outcome or process construct they were trying to measure, the most common constructs were measures of mortality (outcome), length of stay (process) and time-sensitive measures (process). There was heterogeneity in definitions within constructs between studies. There was also a paucity of indicators and potential indicators in the postacute period.ConclusionsTo improve quality of care for patients with hip fracture and create a more efficient healthcare system, mechanisms for the measurement of quality of care across the entire continuum, not just during the acute period, are required. Future research should focus on decreasing the heterogeneity in definitions of quality indicators and the development and implementation of quality indicators for the postacute period.

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“…Fischer et al observed that out of 43 patients who had a Type-IIIB open fracture of the tibial shaft were reviewed to determine the effect of early treatment of the soft-tissue injury on the rate of major complications results show that adequate debridement and early assessment of the soft-tissue defect are necessary so that appropriate soft-tissue coverage can be provided within the first one to two weeks with fewer complication [16].…”

Section: Correlation Of Time Between Injury To Hospital and Delayed Umentioning

confidence: 99%

Epidemiology of Delayed Union of Long Bones

Mehmood¹,

Deshp²,

Khan³

et al. 2017

J Trauma Treat

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Time intervals in the treatment of fractured femurs as indicators of the quality of trauma systems

Cited by 17 publications

References 36 publications

Descriptive Analysis Of Femur Fracture Patterns, Management And Outcome: Descriptive Observational Study From A Level 1 Trauma Center

Descriptive Analysis Of Femur Fracture Patterns, Management And Outcome: Descriptive Observational Study From A Level 1 Trauma Center

Scoping review of potential quality indicators for hip fracture patient care

Epidemiology of Delayed Union of Long Bones

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