[Bipolar hemiarthroplasty in femoral neck fractures--impact of duration of surgery, time of day and the surgeon's experience on the complication rate]

Z Orthop Unfall. Nov-Dec 2009;147(6):689-93. doi: 10.1055/s-0029-1186204. Epub 2009 Dec 8.
[Article in German]

Abstract

Aim: Bipolar hemiarthroplasty is frequently used in femoral neck fractures. There is only little evidence regarding differences in complication rates if the procedure is performed by either a junior or senior surgeon.

Methods: 360 bipolar hemiarthroplasties were retrospectively investigated. Complication rates for junior and senior surgeons were evaluated as well as differences between daytime and nightshift surgery. We also assessed the duration of surgery for the two groups and its impact on the complication rate.

Results: The average duration of the procedure was 67 minutes (23-194) with statistically significant differences between junior and senior surgeons (77 vs. 61 minutes, p < 0.001). Complications occurred in 27 (7.5%) of all cases. Postoperative infections were most frequently found (3.1% of all complications), followed by haematomas and dislocations of the implant (1.7% and 1.1 %, respectively). 25 patients required revision operations. More complications were found in cases performed by junior surgeons (9.56% vs. 6.25%). This difference was not significant (p = 0.248). During on-call duty we also observed more complications compared to daytime surgery (11% vs. 7%). There was no coherence between the duration of surgery and the incidence of complications.

Conclusions: Bipolar hemiarthroplasty is a reliable treatment option for femoral neck fractures even when performed by a junior surgeon. The higher incidence of complications during nighttime surgery should be a reason to perform those cases that are not urgent during the daytime shift.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / education
  • Circadian Rhythm
  • Clinical Competence / standards
  • Cross-Sectional Studies
  • Female
  • Femoral Neck Fractures / epidemiology
  • Femoral Neck Fractures / surgery*
  • Germany
  • Hip Prosthesis*
  • Humans
  • Incidence
  • Internship and Residency
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care / statistics & numerical data
  • Physician Assistants
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology*
  • Prosthesis Design*
  • Quality Assurance, Health Care / standards*
  • Retrospective Studies
  • Time and Motion Studies*
  • Work Schedule Tolerance