Consumption of hospital resources for femoral neck fracture.

In 1,673 patients with femoral neck fracture, the utilization of hospital and rehabilitation resources following primary operations and necessary reoperations was assessed in relation to type of treatment center and outcome of the fracture. All the patients were admitted from their homes to either orthopedic or general surgery departments, urban or rural. The fractures were treated by one of four osteosynthesis methods and followed for 6 years postoperatively. About 30 per cent of the fractures developed healing complications. Patients treated in surgical departments utilized more acute and rehabilitation bed days than those treated in orthopedic departments. The patients stayed longer in city surgical departments than in rural surgical departments. The Thornton osteosynthesis used by general surgical specialists resulted in 29 percent, mainly early complications, whereas the Rydell osteosynthesis used by orthopedic specialists had 24 percent, mainly late complications. This difference resulted in more than 40 percent higher consumption of bed days by the Thornton-nailed patient. In sum, a fracture without complications consumed, on an average, 31 cost standardized bed days compared with 101 bed days for fracture with complications. Thus, every fracture with complications was SEK 112,000 more expensive than the complication-free one.