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Updated: Jan 1, 2026

Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
Clinical pathways for geriatric patients with proximal femoral fracture improve process and outcome
Sandra Tittel1, Janosch Burkhardt1, Christina Roll2
1Department of Orthopaedic and Trauma Surgery, Robert-Bosch-Krankenhaus, Stuttgart, Germany.
Objective:
The objective of the current study was to evaluate the implementation of clinical pathways (CPs) in hip fracture management.
Methods:
Six hundred and five proximal femoral fractures were prospectively included into a hospital data-base. The effects of CPs were evaluated using a pre-during-post design. Different procedural (time to surgery, length of stay, discharge, etc.) and patient outcome parameters (mortality, complications, etc.) were evaluated.
Results:
In both categories significant changes could be detected during the three-year period. E.g. significant reduction of time to surgery, improvement of discharge management, reduction of internal complications. However, no significant changes could be demonstrated for mortality or revision rate.
Conclusion:
We could show a relevant improvement with the implementation of clinical pathways for the treatment of proximal femoral fractures in elderly patients.
Level Of Evidence:
III, prospective non-randomised cohort study.
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