Hip and Fragility Femur Fracture Care 1
Hip and Fragility Femur Fracture Care 1
Advances in caring for our older patients continue, and it’s a fundamental part of every orthopaedic trauma surgeon’s practice. As demonstrated in the ORTHOPOD study, the older injured form the bulk of operative cases on United Kingdom trauma lists across all hospital sites. Central to this population group is those with fractures of the hip, femoral shaft, and distal femur, both native and involving or between implants.
With an average patient stay of around two weeks in acute sites and overall trust bed occupancy of three weeks, the operative element of care must be seen in the perspective of opportunities for care improvement that are available elsewhere. That two-hour period of operation and recovery are surrounded by a host of metrics, many of which are mandatorily audited and rewarded by payment. The National Hip Fracture Database of England and Wales has recently audited its one-millionth patient and is a repository of a wealth of performance information for all hospitals dealing with hip fracture care. The information is freely available for how your hospital is performing and similarly, in Scotland, our Scottish colleagues audit and performance assess their population. Many of these advances are summarised in the REDUCE study. In addition, the many improvement possibilities, audit project suggestions and even business case templates have been taken from REDUCE and are available on the Royal Osteoporosis Society website here.
These mature databases offer not just opportunity for metric assessment but also for improving all aspects of hip fracture care. The NHFD’s annual report carries a surgical section which we would suggest all of the OTS members become familiar with. A summary of the key elements of hip fracture care of 2023 /24 can be watched on demand here.
Every two to three months we will bring to you key updates in specific areas of hip and fragility femur fracture care. The role of arthroplasty, fixation controversies and other surgical issues will be addressed alongside process and non-surgical management such as improving Key Performance Indicators. Of note, non-surgical management, and discussions around managing patients without surgery are gaining attention and will be addressed. We hope to provide education and stimulation for our members, a repository for hip fracture leads and a primer for those studying for exams.
Thanks for the great update, Will. You can read more about Will and the other members of the Research Committee on the Research page.
Please get in touch with any suggestions, particular areas of interest or specialist contributions and we will send out the next instalment by Easter. Contact the OTS