[Proximal femoral fractures in the German external quality assurance module 17/1: reasons for delay in surgery]
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Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
T Ruffing1, D Klein, P Huchzermeier
1Klinik für Unfallchirurgie und Orthopädie 1, Westpfalz-Klinikum GmbH, Hellmut-Hartert-Strasse 1, 67655, Kaiserslautern, Deutschland. thomas@ruffing.eu
Background:
For the quality indicator "preoperative stay" a part of the external quality assurance for proximal femoral fractures (module 17/1), a tolerance range for surgery within 48 h after admission of ≤ 15 % is given.
Materials And Methods:
Over a period of 5 years all cases were analyzed with respect to reasons for delayed surgery of more than 48 h after admission.
Results:
A total of 165 patients (16%) out of 1,036 documented cases had surgery later than 48 h after admission. Reasons were pathological bleeding, preoperative poor general condition, lack of informed consent, intake of metformin and lacking initial radiological detection of fractures. Due to a lack of software-related specifications in ten patients a wrong preoperative length of stay was generated.
Conclusion:
The significance of the quality indicator "preoperative stay" without division into whether this was administrative or patient-related must be considered critically. For fall-related fractures in hospital the time of the accident or diagnosis should be considered.
