DELAYED OPERATIVE FIXATION OF FEMUR FRACTURES IS A RISK FACTOR FOR PULMONARY FAILURE INDEPENDENT OF THORACIC TRAUMA

1993 ◽  
Vol 35 (6) ◽  
pp. 983
Author(s):  
William E. Charash ◽  
Timothy C. Fabian ◽  
Martin A. Groce
2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
O Brown ◽  
A Gaukroger ◽  
M Raza ◽  
R Sturley ◽  
M Arnander

Abstract Aim Neck of femur fractures (NOFs) are synonymous with frailty, and successful outcomes are achieved with operative fixation. The United Kingdom’s General Medical Council guidance governing consent highlights the importance of thorough pre-operative discussion of risk with the patient. We aimed to audit consenting practices in NOF patients within our unit against the British Orthopaedic Association’s (BOA) criteria, with the addition of delirium as a risk factor. Method In cycle one all operatively managed NOFs over a two-month period in October-November 2019 were retrospectively reviewed. Consent forms 1 (CF1) and 4 (CF4) were assessed against BOA-endorsed criteria. Our intervention included a standardised sticker detailing 14 important risks was introduced and a departmental seminar on delirium. A second cycle was undertaken from August-October 2020 to close the audit loop Results No consent form documented all BOA-approved risk factors in cycle one (N = 35). Of cycle two’s 35 patients, 70.8% CF1 were completed using the novel sticker. All of these had 100% BOA-approved risk documentation. Consent forms without the sticker in cycle two documented 9/14 risks (mean value). No CF4 had any risks documented in either cycle. Delirium was documented in 51% in total and in 75% patients with CF1. Delirium documentation improved from 2.9% in cycle one to 51.4% in cycle two. Conclusions Clear lapses in operative consenting processes were identified, especially regarding delirium and CF4 documentation. The introduction of a novel consent sticker drastically improved compliance with BOA guidance for CF1. Recognition and departmental education regarding delirium significantly reduced incidence between cycles.


2010 ◽  
Vol 25 (1) ◽  
pp. 81
Author(s):  
Bolarinwa Akinola ◽  
Henry Wynn-Jones ◽  
Tim Harrison ◽  
Nish Chirodian

2012 ◽  
Vol 470 (8) ◽  
pp. 2295-2301 ◽  
Author(s):  
Mark L. Prasarn ◽  
Jaimo Ahn ◽  
David L. Helfet ◽  
Joseph M. Lane ◽  
Dean G. Lorich

2017 ◽  
Vol 225 (4) ◽  
pp. e177
Author(s):  
Xin Huang ◽  
Lou J. Magnotti ◽  
Timothy C. Fabian ◽  
Martin A. Croce ◽  
John Sharpe

Injury ◽  
2019 ◽  
Vol 50 (11) ◽  
pp. 2089-2092 ◽  
Author(s):  
G. Chan ◽  
E. Iliopoulos ◽  
A. Jain ◽  
M. Turki ◽  
A. Trompeter

JRSM Open ◽  
2017 ◽  
Vol 8 (3) ◽  
pp. 205427041667508 ◽  
Author(s):  
Rafik RD Yassa ◽  
Mahdi Y Khalfaoui ◽  
Karunakar Veravalli ◽  
D Alun Evans

Objective The aims of the current study were to determine whether pre-operative urinary tract infections in patients presenting acutely with neck of femur fractures resulted in a delay to surgery and whether such patients were at increased risk of developing post-operative surgical site infections. Design A retrospective review of all patients presenting with a neck of femur fracture, at a single centre over a one-year period. The hospital hip fracture database was used as the main source of data. Setting UK University Teaching Hospital Participants All patients ( n = 460) presenting across a single year study period with a confirmed hip fracture. Outcome measures The presence of pre-operative urinary tract infection, the timing of surgical intervention, the occurrence of post-operative surgical site infection and the pathogens identified. Results A total of 367 patients were operated upon within 24 hours of admission. Urinary infections were the least common cause of delay. A total of 99 patients (21.5%) had pre-operative urinary tract infection. Post-operatively, a total of 57 (12.4%) patients developed a surgical site infection. Among the latter, 31 (54.4%) did not have a pre-operative urinary infection, 23 (40.4%) patients had a pre-operative urinary tract infection, 2 had chronic leg ulcers and one patient had a pre-operative chest infection. Statistically, there was a strong relationship between pre-operative urinary tract infection and the development of post-operative surgical site infection ( p-value: 0.0005). Conclusion The results of our study indicate that pre-operative urinary tract infection has a high prevalence amongst those presenting with neck of femur fractures, and this is a risk factor for the later development of post-operative surgical site infection.


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