Abstract
Relevance. An in-house Protocol for proximal femoral fracture management was developed at Vsevolozhsk Clinical Interdistrict Hospital of Leningrad Region.Intention To demonstrate possible practical application of preliminary federal clinical guidelines at Level 1 trauma center in Leningrad Region including comparative analysis of its efficacy when treating intertrochanteric femoral fractures.Methodology. Post-surgery outcomes were retrospectively assessed in 86 patients of Vsevolozhsk Clinical Interdistrict Hospital (Group 1, per Protocol) and 28 patients of Tosno Clinical Interdistrict Hospital (Group 2, w/o Protocol) with intertrochanteric femoral fractures (31A by Arbeitsgemeinschaft für Osteosynthesefragen classification and S72.1 by ICD-10).Results and Discussion. There were no significant differences in patients’ age, methods of anesthesia and osteosynthesis between the groups. Group 1 demonstrated statistically significant decrease in preoperative bed-days, time to sitting up in bed after surgery, ambulation with walkers and duration of hospitalization. Group 1 patients needed less assistance from other health-care professionals, less intensive therapy and blood transfusions.Conclusion. Adoption of in-house protocols, optimization of supply and staffing as well as involvement of multidisciplinary teams will improve management of proximal femoral fractures.
Highlights
An in-house Protocol for proximal femoral fracture management was developed at Vsevolozhsk Clinical Interdistrict Hospital of Leningrad Region
Post-surgery outcomes were retrospectively assessed in 86 patients of Vsevolozhsk Clinical Interdistrict Hospital (Group 1, per Protocol) and 28 patients of Tosno Clinical Interdistrict Hospital (Group 2, w/o Protocol) with intertrochanteric femoral fractures (31A by Arbeitsgemeinschaft für Osteosynthesefragen classification and S72.1 by ICD-10)
There were no significant differences in patients’ age, methods of anesthesia and osteosynthesis between the groups
Summary
Лет Время от поступления до операции, сут Длительность операции, мин Срок усаживания в постели, сут Срок начала ходьбы с дополнительной опорой, сут Койко-день, сут Умерли пациентов / летальность, %. Летальность во 2-й группе со ентам 1-й группы, на основании этого можно ставила 3,6 %. Сделать вывод, что у 74,4 % пациентов для Сравнительные результаты лечения пациен решения вопроса о тактике лечения доста тов обеих клинических групп сведены в табл. В то же время, во 2-й группе дерно-возрастным характеристикам. Этот тологу потребовался 17 пациентам (60,7 %), факт позволял сравнить результаты проведен что может косвенно свидетельствовать – дли ного хирургического лечения интрамедулляр тельные предоперационный период и им ного блокируемого остеосинтеза при ППОБК мобилизация способствуют декомпенсации в обеих группах и сделать определенные вы хронических заболеваний и приводят к необ воды из полученных данных
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