DOS BULLETIN - Dansk Ortopædisk Selskab
DOS BULLETIN - Dansk Ortopædisk Selskab DOS BULLETIN - Dansk Ortopædisk Selskab
2010-378_DOS nr. 3 2010 29/09/10 10:08 Side 94 Complications and functional outcome after internal fixation of dorsally displaced distal radial fractures Jeppe Bove, Bjarke Viberg, Pernille Greisen, Jan Schultz Hansen OUH Svendborg Ortopædkirurgisk afdeling; OUH Svendborg Radiologisk afdeling Background: Recently there has been an increasing interest in open reduction and internal fixation of distal radius fractures. Even so further studies are still needed. Purpose: To document the functional outcome and identify complications among patients treated with a volar locking plate (DVR-locking plate, DePuy Orthopaedics) newly introduced in our department. Methods: The study was designed as a historical cohort study. 37 females and 6 males with a mean (CI) age of 72,6 (69,5-75,6) were included. 35 received 6 months follow up (median 6,4) and 30 received 1 year follow up (median 14,0). Outcome measures included the Disability of the Arm, shoulder and Hand (DASH) questionnaire, grip strength, active wrist and forearm range of motion and radiographic parameters. Findings: The mean DASH score was 15,5 (10,5- 20,6) at 6 months and 6,3 (2,5-10) at 1 year. There were at 1 year statistical significant difference between the fractured and non-fractured wrist for flexion, extension and grip strength but not for supination and pronation. X-rays showed an improvement from preoperative to postoperative in dorsal angulation (17,7 degrees), inclination (6,6 degrees) and radial length (4,8 mm). A total of 10 major complications were identified: 4 had screws in the joint, 2 tendon ruptures, 2 plates were removed, 1 carpal tunnel syndrome, 1 lacking radiological healing. There were no association between major complications and the surgeons experience level (> 10 operations). Evaluation of the X-ray images showed 14 cases of too radial plate placement and 1 one forgotten tower. Conclusion: The literature describes an overall complication frequency between 0 and 27%, with a lower frequency of secondary procedures compared to this study. There is still a need for further studies 94
2010-378_DOS nr. 3 2010 29/09/10 10:08 Side 95 The Hvidovre Algorithm for hip fracture surgery reduced the 1-year reoperation rate from 18% to 12% Henrik Palm, Michael Krasheninnikoff, Kim Holck, Nicolai Foss, Henrik Kehlet, Peter Gebuhr Department of Orthopaedic Surgery, Copenhagen University Hospital of Hvidovre; Department of Anaesthesiology, Copenhagen University Hospital of Hvidovre; Section of Surgical Pathophysiology, the Juliane Marie Centre, Rigshospitalet Background: We implemented an exhaustive operative and supervision algorithm for surgical treatment of hip fractures primarily based on own previously published literature. Purpose: Our aim was to improve supervision and reduce the rate of reoperations. Methods: 2000 consecutive patients >50 years admitted with a hip fracture were included, 1000 of these prospectively after implementation of the algorithm. Demographic parameters, hospital treatment and reoperations within the first postoperative year were assessed from patient records. Findings: 931/1000 operative procedures were operated according to the algorithm, compared to only 726/1000 prior to its introduction (p
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2010-378_<strong>DOS</strong> nr. 3 2010 29/09/10 10:08 Side 95<br />
The Hvidovre Algorithm for hip fracture surgery<br />
reduced the 1-year reoperation rate from 18% to 12%<br />
Henrik Palm, Michael Krasheninnikoff, Kim Holck, Nicolai Foss,<br />
Henrik Kehlet, Peter Gebuhr<br />
Department of Orthopaedic Surgery, Copenhagen University Hospital<br />
of Hvidovre; Department of Anaesthesiology, Copenhagen University<br />
Hospital of Hvidovre; Section of Surgical Pathophysiology,<br />
the Juliane Marie Centre, Rigshospitalet<br />
Background: We implemented an exhaustive operative and supervision<br />
algorithm for surgical treatment of hip fractures primarily based on own<br />
previously published literature.<br />
Purpose: Our aim was to improve supervision and reduce the rate of<br />
reoperations.<br />
Methods: 2000 consecutive patients >50 years admitted with a hip fracture<br />
were included, 1000 of these prospectively after implementation of<br />
the algorithm. Demographic parameters, hospital treatment and reoperations<br />
within the first postoperative year were assessed from patient<br />
records.<br />
Findings: 931/1000 operative procedures were operated according to<br />
the algorithm, compared to only 726/1000 prior to its introduction<br />
(p
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