Summary
The incidence of the major complications of operation have been studied prospectively in 1,722 patients with a proximal femoral fracture treated by either insertion of a hemiarthroplasty, internal fixation with a Dynamic Hip Screw (DHS) or multiple parallel screws. Major complications occurred in 8.0%. A special surgical “Hip Fracture Team” reduced the incidence of major complications from 12.5% to 5.0%. The most significant benefit from employment of the special team was in reducing the incidence of wound sepsis and of failure of fixation following the operative management of displaced intracapsular and extracapsular fractures. Assigning hip fracture surgery to designated personel will result in a significant reduction in morbidity.
Résumé
On a étudié de façon prospective la fréquence des complications chirurgicales majeures sur une série de 1722 patients atteints de fracture de l'extrémité supérieure du fémur, traités soit par hémi-arthroplastie, soit par ostéosynthèse avec une Dynamic Hip Screw (DHS) ou avec plusieurs vis parallèles. La fréquence totale des complications majeures était de 8%. Elle a été réduite de 12.5% à 5% grâce au recours à une équipe chirurgicale spécialisée. Le bénéfice le plus significatif obtenu par ce personnel spécialisé a été la réduction du nombre d'infections post-opératoires ainsi que celui des échecs de la fixation interne dans les fractures intra- ou extracapsulaires avec déplacement. En confiant à une équipe particulière la chirurgie des fractures de la hanche, on obtiendra une diminution notable de la morbidité postopératoire.
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Parker, M.J., Pryor, G.A. & Myles, J.W. The value of a special surgical team in preventing complications in the treatment of hip fractures. International Orthopaedics 18, 184–188 (1994). https://doi.org/10.1007/BF00192477
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DOI: https://doi.org/10.1007/BF00192477