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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 1,
77-79.
doi: 10.1302/0301-620X.89B1.18316 Copyright © 2007 by British Editorial Society of Bone and Joint Surgery Operative delay for fracture of the hipA TWO-CENTRE PROSPECTIVE STUDYN. Von Meibom, MB BS, Orthopaedic Senior House Officer1; N. Gilson, MB BS, Orthopaedic Senior House Officer2; A. Dhapre, MRCS, Orthopaedic Registrar2; and B. Davis, MRCS, Orthopaedic Specialist Registrar3
1 Department of Trauma and Orthopaedic Surgery, West Suffolk NHS Trust, Hardwick Lane, Bury St Edmunds, IP33 2QZ, UK. Correspondence should be sent to Mr B. Davis at 27 Wrights Way, Woolpit, Bury St Edmunds, IP30 9TY, UK; e-mail: bjdavis{at}doctors.net.uk
We undertook a simultaneous prospective two-centre study to examine why patients with fractures of the proximal femur experience a delay in undergoing surgery. At centre 1, 23 of 105 patients (22%) suffered an avoidable delay, 18 (78%) because of a lack of theatre capacity while at centre 2, 71 of 130 patients (55%) had an avoidable delay, with 54 (76%) because of this cause. Miscellaneous reasons such as poor ward management, co-existing medical conditions, and lack of equipment were responsible for the remainder of the delays. Without a substantial increase in operating capacity for acute trauma, it will not be possible to comply with guidelines which recommend surgical treatment within 24 hours in elderly and vulnerable patients.
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