Travmatologiâ i Ortopediâ Rossii (Jun 2016)

COHORT STRUCTURE OF PATIENTS WITH PROXIMAL FEMUR FRACTURES AND ESTIMATION OF AVERAGE ANNUAL DEMAND FOR EMERGENCY SURGICAL TREATMENT

  • T. N. Vorontsova,
  • A. S. Bogopol’skaya,
  • A. Z. Cherny,
  • S. B. Shevchenko

DOI
https://doi.org/10.21823/2311-2905-2016-0-1-7-20
Journal volume & issue
Vol. 0, no. 1
pp. 7 – 20

Abstract

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The aim of this study is to examine cohort structure of patients with proximal femoral fractures (PFF) and estimate an average annual demand in emergency surgical treatment for St. Petersburg adult population with mentioned diagnosis. Material and methods. The authors examined case histories and radiographs of 1412 adult patients with proximal femur fractures admitted to three St. Petersburg large general hospitals during one year. Analysis was done using statistical and expert evaluation methods.Results. Cohort structure of patients with PFF demonstrated the following distribution: female – 71,7%, male – 28,3%; Patients of elderly group prevailed: 70 years and older – 70,6%, 60–69 years old – 12%, 50–59 years old – 10,8%; Retirees with various disability status – 80%. Injury structure showed prevalence of femoral neck fractures –52%, pertrochanteric fractures represented 42%, subtrochanteric fractures – 5%. 11,3 days was the average time span from injury till surgery. The authors separately estimated urgent surgical treatment demand for patients with femoral neck fractures and patients with trochanteric fractures. Consequently, both groups results were summed up to generate the total average annual demand for emergency operative treatment for PFF which for adult population of St. Petersburg amounted to 4098 interventions, meaning one surgery per one thousand of adults.Conclusions. Absence of a common consistent approach to treatment of patients with proximal femur fractures as well as significant variance among St. Petersburg hospitals in respect of material, technical and staff resources result in a situation when not every patient with PFF undergoes surgical treatment. There is a strong need to develop and regulate implementation of a standardized treatment algorithm for such injuries, to improve infrastructure and resources of St. Petersburg general hospitals as well as to continuously monitor quality of medical treatment for patients with PFF.

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