807 Lower Limb Pathological Fracture Audit

Abstract

Abstract Aim To minimise the delays in surgical management and differentiate among patients with suspected and not suspected pathological fracture. Method Review of all patients admitted since January 2022 with pathological fracture or suspected Pathological fracture. Reviewed gospels (previous recorded/saved files) and then ECR/radiology systems for outcomes. All spinal patients and all upper limb patients were excluded as they are ambulatory. Results Initially identified 24 patients, 10 excluded and 14 patients included. 10 were females and 14 were males. Mean age was 69 (range 45 – 90). Majority site of lesions were on hip (with 11 patients). Majority of investigations were CT scan, MRI and bone scan which took mean time of 14 days for completion and mean time to theatre was 26 days. Mean length of stay – 21 days (range 3 – 77, mean 16 with outliers excluded). 50% patients died at 6 months follow up. 1 patient passed away as inpatient and 1 dislocated Pelvic floor repair but was not suitable for further surgery whereas 1 requiring return to theatre for washout and debridement. Conclusions A patient with a suspected pathological fracture is at risk of hugely significant delay to life saving or life prolonging operation. Patient who requires biopsy at present will not get to theatre within 3 weeks of injury.