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Il timing nel trattamento delle fratture del femore prossimale

Timing in the treatment of patients with hip fracture

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LO SCALPELLO-OTODI Educational

Abstract

We assess the relationship between surgical delay, mortality, morbidity, complications and final outcome in patients with hip fracture.

Historic studies, systematic reviews, meta-analyses, retrospective and prospective studies were analyzed to explore factors associated with the decision to perform early repair in cases of hip fracture and its outcome.

The weak relation between timing and death is confounded by chronic comorbidities and not controlled with multivariate, logistic and/or instrumental variable analysis. Complications and duration of pain have strong relation with time to surgery.

Conclusions: surgical delay is associated with a certain risk of death, of pressure sores and of avoidable pain. Conservative timing strategies should be avoided. Orthopaedic surgery services should ensure that the majority of patients are operated within two days, but a good management model is needed to provide a feasible allocation of urgent and semi-urgent surgeries.

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  1. UO Ortopedia e Traumatologia Ospedale Misericordia e Dolce, Azienda Usl 4, Prato, PO, Italy

    Giovanni Benelli

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  1. Giovanni Benelli
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Correspondence to Giovanni Benelli.

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Benelli, G. Il timing nel trattamento delle fratture del femore prossimale. LO SCALPELLO 27, 41–44 (2013). https://doi.org/10.1007/s11639-013-0028-6

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